Risk Factors for the Recurrence of Posterior Communicating Artery Aneurysm: The Significance of Fetal-Type Posterior Cerebral artery

There are many potential anatomical variations in the connection between the internal carotid artery and the posterior circulation through the posterior communicating artery (PCoA). We describe the endovascular treatment of an aneurysm arising near the origin of the PCoA belonging to a transitional type posterior cerebral artery. Coil embolization subsequently resulted in thrombo-occlusion of the adjacent PCoA causing thalamic infarction even though sufficient retrograde flow had been confirmed pre-operatively by Allcock's test.

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Posterior Cerebral Artery Aneurysm: Pediatric Giant Non-saccular Posterior Cerebral Artery Aneurysm Treated with a Scaffold Stent, Double Flow Diverters, and Posterior Communicating Artery Disconnection by Coiling

The Aneurysm Casebook ◽

10.1007/978-3-319-70267-4_171-1 ◽

2020 ◽

pp. 1-9

Author(s):

José E. Cohen ◽

John M. Gomori ◽

Shalom Mijovich ◽

Moatasim Shweiki ◽

Gustavo Rajz

Keyword(s):

Cerebral Artery ◽

Posterior Cerebral Artery ◽

Artery Aneurysm ◽

Posterior Communicating Artery ◽

Cerebral Artery Aneurysm ◽

Flow Diverters

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Morphological and clinical risk factors for the rupture of posterior communicating artery aneurysms: significance of fetal-type posterior cerebral artery

Neurological Sciences ◽

10.1007/s10072-019-03991-4 ◽

2019 ◽

Vol 40 (11) ◽

pp. 2377-2382 ◽

Cited By ~ 2

Author(s):

ZhengHu Xu ◽

Bum Soo Kim ◽

Kwan Sung Lee ◽

Jai Ho Choi ◽

Yong Sam Shin

Keyword(s):

Risk Factors ◽

Cerebral Artery ◽

Posterior Cerebral Artery ◽

Posterior Communicating Artery ◽

Clinical Risk Factors ◽

Clinical Risk

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Dividing the Posterior Communicating Artery in Approaches to the Interpeduncular Fossa: Technical Aspects and Safety

Operative Neurosurgery ◽

10.1227/01.neu.0000303998.20268.6e ◽

2007 ◽

Vol 61 (suppl_5) ◽

pp. ONSE392-ONSE397 ◽

Cited By ~ 8

Author(s):

Niklaus Krayenbühl ◽

Ali F. Krisht

Keyword(s):

Risk Factors ◽

Cerebral Artery ◽

Posterior Cerebral Artery ◽

Postoperative Bleeding ◽

Posterior Communicating Artery ◽

Vascular Risk ◽

Technical Aspects ◽

Free Zone ◽

Neoplastic Lesions ◽

Ischemic Complications

Abstract Objective: Cutting the posterior communicating artery (PComA) can improve the neurosurgeon's view and maneuverability while performing surgery within the interpedun-cular fossa. Although mentioned in some reports, its technique and safety have not been studied in detail thus far. Methods: Patients undergoing surgery for vascular and neoplastic lesions in the interpeduncular fossa in which the PComA was cut were retrospectively analyzed regarding the location where the PComA was divided, the size of the PComA in relation to the posterior cerebral artery, and the vascular risk factors. Clinical and radiological outcomes and the related complications were recorded and analyzed. Results: The PComA was divided in 25 patients, and was operated on for vascular (in 23 patients) and neoplastic (in 2 patients) lesions. The PComA was divided at a perforator-free-zone. This zone was most commonly located at the junction of the PComA and the posterior cerebral artery (88% of patients). One patient had delayed postoperative bleeding from the divided PComA stump. There were no ischemic complications either in the territory of the PComA perforator or in the posterior cerebral artery. Conclusion: This is the largest reported experience with dividing the PComA. It shows that this surgical step is safe and that it constitutes an important option to help improve the exposure, maneuverability, and safety of surgery in the region of the interpeduncular fossa.

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Premammillary Artery Infarction after Microsurgical Clipping of Unruptured Posterior Communicating Artery Aneurysm: Risk Factors, Surgical, and Anatomical Considerations

10.21203/rs.3.rs-1018024/v1 ◽

2021 ◽

Author(s):

JONG MIN LEE ◽

Joon Ho Byun ◽

Seungjoo Lee ◽

Eun Suk Park ◽

Jung Cheol Park ◽

...

Keyword(s):

Risk Factors ◽

Multivariate Logistic Regression Analysis ◽

Length Of Hospital Stay ◽

Artery Aneurysm ◽

Normal Group ◽

Posterior Communicating Artery ◽

Microsurgical Clipping ◽

Posterior Communicating Artery Aneurysm ◽

Independent Risk Factors ◽

The Mean

Abstract Purpose Posterior communicating artery (PCoA) aneurysm is common and sometimes requires microsurgery; however, as data on premammillary artery (PMA) infarction after clipping is scarce, we retrospectively reviewed cases of post-clipping PMA infarction to analyze incidence, independent risk factors of infarction, and anatomical considerations. Methods Data from 569 consecutive patients who underwent microsurgical clipping for unruptured PCoA aneurysm between January 2008 and December 2020 were included. Patients were categorized into the normal or the PMA infarction group. Statistical analyses and comparisons between the two groups were used to determine the influence of various factors. Results The normal group included 515 patients while the PMA infarction group had 31. The mean length of hospital stay was significantly longer in the PMA infarction group (10.3 ± 9.1 days) than in the normal group (6.5 ± 6.4 days; p < 0.0001). The distribution of Glasgow Outcome Scale (GOS) at discharge was significantly different between the two groups (p ≤ 0.0001) but was not so at 6 months after discharge (p = 0.0568). Multivariate-logistic-regression analysis identified aneurysm size (odds ratio [OR], 1.194; 95% confidence interval [CI], 1.08–1.32; p = 0.0005) and medial direction of aneurysm (OR, 4.615; 95% CI, 1.224–17.406; p = 0.0239) as independent risk factors of post-clipping PMA infarction. Conclusions Surgeons must beware of PMA infarction after clipping of large aneurysms that are medial in direction. Intraoperative verification of the patency of the PCoA and the PMA from various angles using various intraoperative methods can reduce morbidity due to PMA infarction.

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Horizontal Stenting via Retrograde Route for Recurrent Ruptured Posterior Communicating Artery Aneurysm after Clipping: A Case Report and Literature Review

10.22541/au.163546088.82130863/v1 ◽

2021 ◽

Author(s):

Michiyasu Fuga ◽

Toshihide Tanaka ◽

Rintaro Tachi ◽

Ryo Nogami ◽

Akihiko Teshigawara ◽

...

Keyword(s):

Case Report ◽

Internal Carotid ◽

Posterior Cerebral Artery ◽

Artery Aneurysm ◽

Posterior Communicating Artery ◽

Coil Embolisation ◽

Ruptured Aneurysms ◽

Branch Vessel ◽

Posterior Communicating Artery Aneurysm ◽

Contralateral Internal Carotid Artery

Treatment of recurrent ruptured aneurysms incorporating a branch vessel arising from the dome is challenging. Here, we attempted horizontal stent-assisted coil embolisation via a retrograde route from the contralateral internal carotid artery to treat a small ruptured posterior communicating artery aneurysm incorporating a foetal variant posterior cerebral artery after clipping.

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