Abstract
Purpose
Whether the posterior communicating artery (PcomA) can be safely compromised during endovascular treatment of a PcomA aneurysm is a matter of debate. Here we present clinical and radiologic outcomes, given this scenario.
Methods
From data prospectively accrued between January 2004 and December 2012, records of 44 patients harboring 46 PcomA aneurysms were retrieved. All had suffered PcomA compromise in the course of endovascular coil embolization. Patients/aneurysms were stratified into those with complete (Group A) and incomplete (Group B) compromise depending on the degree of PcomA flow limitation documented by postembolization ipsilateral internal carotid artery angiography. Clinical and radiologic outcomes were accordingly assessed.
Results
All affected vessels were hypoplastic PcomA variants (PcomA/P1 ratio, ≤ 1.0), with exception of a single dominant PcomA (PcomA/P1 ratio, 1.1). In Group A (23 patients, 23 aneurysms), no PcomA compromise-related infarction was evident, whereas in Group B (21 patients, 23 aneurysms), two ischemic events occurred. One patient suffered thalamic infarction, although patency of the PcomA was adequate in a follow-up angiogram, and another experienced a transient ischemic attack.
Conclusion
Our findings suggest that obstructed flow in hypoplastic PcomA variants during coil embolization of PcomA aneurysms carries no major consequence. However, incomplete compromise of the PcomA may be a source of delayed thromboembolic infarction.
Similar content being viewed by others
Abbreviations
- DSA:
-
Digital subtraction angiography
- GOS:
-
Glasgow outcome scale
- ICA:
-
Internal carotid artery
- PcomA:
-
Posterior communicating artery
- SAH:
-
Subarachnoid hemorrhage
- VA:
-
Vertebral artery
References
He W, Gandhi CD, Quinn J, Karimi R, Prestigiacomo CJ. True aneurysms of the posterior communicating artery: a systematic review and meta-analysis of individual patient data. World Neurosurg. 2011;75:64–72.
Golshani K, Ferrell A, Zomorodi A, Smith TP, Britz GW. A review of the management of posterior communicating artery aneurysms in the modern era. Surg Neurol Int. 2010;1:88.
Kang HS, Kwon BJ, Kim JE, Han MH. Preinterventional clopidogrel response variability for coil embolization of intracranial aneurysms: clinical implications. AJNR Am J Neuroradiol. 2010;31:1206–10.
Raymond J, Guilbert F, Weill A, Georganos SA, Juravsky L, Lambert A, Lamoureux J, Chagnon M, Roy D. Long-term angiographic recurrences after selective endovascular treatment of aneurysms with detachable coils. Stroke. 2003;34:1398–403.
Cho YD, Lee WJ, Kim KM, Kang HS, Kim JE, Han MH. Stent-assisted coil embolization of posterior communicating artery aneurysms. AJNR Am J Neuroradiol. 2013;34:2171–6.
Endo H, Sato K, Kondo R, Matsumoto Y, Takahashi A, Tominaga T. Tuberothalamic artery infarctions following coil embolization of ruptured posterior communicating artery aneurysms with posterior communicating artery sacrifice. AJNR Am J Neuroradiol. 2012;33:500–6.
Acknowledgment
This study was supported by a grant of the Korea Healthcare Technology R&D Project, Ministry for Health, Welfare & Family Affairs, Republic of Korea (A111101).
Conflict of Interest
The authors declare that there are no actual or potential conflicts of interest in relation to this article.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Cho, Y., Jung, S., Kim, C. et al. Posterior Communicating Artery Compromise in Coil Embolization of Posterior Communicating Artery Aneurysms. Clin Neuroradiol 25, 275–279 (2015). https://doi.org/10.1007/s00062-014-0308-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00062-014-0308-4