Five-year follow-up of stenting for a symptomatic posterior cerebral artery stenosis

2011 ◽  
Vol 59 (3) ◽  
pp. 405
Author(s):  
Kangning Chen ◽  
Wei Chen ◽  
Jun Hu ◽  
Xiaofei Zhang ◽  
Shugui Shi
Keyword(s):  
Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Artery Stenosis

Reduced Efficacy of the Pipeline Embolization Device in the Treatment of Posterior Communicating Region Aneurysms with Fetal Posterior Cerebral Artery Configuration

Neurosurgery ◽  
2017 ◽  
Vol 82 (5) ◽  
pp. 695-700 ◽  
Author(s):  
Anil K Roy ◽  
Brian M Howard ◽  
Diogo C Haussen ◽  
Joshua W Osbun ◽  
Sameer H Halani ◽  
...  
Keyword(s):  
Cerebral Artery ◽  
Clinical Symptoms ◽  
Posterior Cerebral Artery ◽  
Neurological Complications ◽  
Class I ◽  
Class Iii ◽  
Pipeline Embolization Device ◽  
Independent Association ◽  
Incomplete Occlusion

Abstract BACKGROUND Aneurysms at the origin of the posterior communicating artery (PcommA) have been demonstrated to be effectively treated with the pipeline embolization device (PED). Much less is known about the efficacy of the PED for aneurysms associated with a fetal posterior cerebral artery (fPCA) variant. OBJECTIVE To study PED treatment efficacy of PcommA aneurysms, including fPCA aneurysms. METHODS A prospectively maintained university database of aneurysm patients treated with the PED was retrospectively reviewed. Demographics, treatment details, and imaging were reviewed for all PcommA and fPCA aneurysms. RESULTS Out of a total of 285 patients treated with PED, 50 patients (mean age 57.5 ± 12.2 yr, 42 females) with unruptured PcommA (9 fPCA) aneurysms were identified. Mean follow-up duration was 14.0 ± 11.6 mo (48 patients). Roy-Raymond class I occlusion on follow-up magnetic resonance or catheter angiography (mean time 11.7 ± 6.8 mo) was achieved in 30 patients (62.5%), class II occlusion in 11 patients (22.9%) and class III occlusion in 7 patients (14.5%). The PcommA was occluded in 56% of patients without any clinical symptoms. No deaths or permanent neurological complications occurred. In fPCA aneurysms, class I occlusion was seen in 1 patient, class 2 occlusion in 2 patients, and class III occlusion in 6 patients. Multivariate analysis revealed an independent association between incomplete occlusion and fPCA configuration (OR 73.65; 95% CI: 5.84-929.13; P = .001). CONCLUSION The PED is a safe and effective treatment for PcommA aneurysms, although fetal anatomy should increase consideration of traditional endovascular techniques or surgical clipping.

Endovascular therapy for posterior communicating artery-infundibular dilatation aneurysms

2021 ◽  
Vol 7 (6) ◽  
pp. 6511-6518
Author(s):  
Xinggen Fang ◽  
Degang Wu ◽  
Niansheng Lai ◽  
Jinlong Yuan ◽  
Zhenbao Li ◽  
...  
Keyword(s):  
Cerebral Artery ◽  
Endovascular Therapy ◽  
Internal Carotid ◽  
Posterior Cerebral Artery ◽  
Posterior Communicating Artery ◽  
Vertebral Angiography ◽  
Ruptured Aneurysms ◽  
Aneurysm Embolization ◽  
Lost To Follow Up

Objective: The purpose of this study was to explore the effect of endovascular therapy on posterior communicating artery-infundibular dilatation aneurysms. Methods: A total of 15 patients with ruptured aneurysms caused by posterior communicating artery-infundibular dilatation who were treated in our neurosurgical center from January 2015 to December 2018were included in this study. They were performed with bilateral internal carotid angiography and vertebral angiography and treated with endovascular method. The modified Rankin Scale (mRS) was used for clinical follow-up for 18 months. Results: There were 10 patients in the posterior communicating artery-infundibular dilatation aneurysms with non-fetal posterior cerebral artery. Among them, 8 patients were treated with coil-alone embolization. Immediate imaging showed infundibular dilation residual in 6 cases and no contrast filling in either infundibular dilation or aneurysm in 2 case. Another 2 were treated with stent-assisted coiling embolization, and immediate imaging showed no contrast filling. Of the 5 patients in posterior communicating artery-infundibular dilatation aneurysms with fetal posterior cerebral artery, 4 were only coiled in the aneurysm sack with contrast filling in infundibular cones, and 2 were treated with stent assisted coiling. Among the 10 patients with non-fetal posterior cerebral artery, 3 showed recurrence, 4 showed stable images, 2 were also stable with no contrast filling in infundibular dilation or aneurysm and 1 was lost to follow-up. Among the 5 patients with fetal posterior cerebral artery, 1 showed stable images, 3 showed recurrence and 1 was lost to follow-up. Conclusions: For posterior communicating artery-infundibular dilatation aneurysms with non-fetal posterior cerebral artery, stent-assisted coiling of aneurysm embolization combined with occlusion of cones is effective to prevent or reduce recurrence.

De novo giant posterior cerebral artery aneurysm developing 25 years after basilar bifurcation aneurysm treatment using a Drake tourniquet: case report and implications for aneurysm follow-up

2018 ◽  
Vol 128 (4) ◽  
pp. 1028-1031
Author(s):  
Rafael Martinez-Perez ◽  
David M. Pelz ◽  
Stephen P. Lownie
Keyword(s):  
Cerebral Artery ◽  
De Novo ◽  
Posterior Cerebral Artery ◽  
Rare Complication ◽  
Young Patients ◽  
Artery Aneurysm ◽  
First Case ◽  
Bifurcation Aneurysm ◽  
De Novo Aneurysm

The objective of this paper was to report a rare complication of basilar artery (BA) tourniquet treatment of a giant basilar tip aneurysm, and to discuss possible causes for the formation of a de novo giant posterior cerebral artery (PCA) aneurysm. A 34-year-old woman underwent satisfactory treatment of a ruptured giant basilar bifurcation aneurysm by BA ligation (Drake tourniquet) in 1985. She presented 25 years later with a new aneurysm in the left PCA, successfully treated by coil embolization. To the authors’ knowledge, this is the first case of de novo aneurysm formation on a PCA, and the first de novo aneurysm reported as a complication of BA ligation therapy by Drake tourniquet. Long-term follow-up is necessary in patients with treated cerebral aneurysms, particularly those occurring in young patients, those with multiple aneurysms, those with complex posterior circulation aneurysms, and those undergoing flow diversion or flow-altering therapies.

scholarly journals Endovascular treatment of posterior cerebral artery aneurysms: a single center's experience of 55 cases

2017 ◽  
Vol 126 (4) ◽  
pp. 1094-1105 ◽  
Author(s):  
Xuanfeng Qin ◽  
Feng Xu ◽  
Yashengjiang Maimaiti ◽  
Yongtao Zheng ◽  
Bin Xu ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Case Series ◽  
Artery Occlusion ◽  
Dissecting Aneurysm ◽  
Attractive Alternative ◽  
Parent Artery ◽  
Parent Artery Occlusion

OBJECTIVE Aneurysms of the posterior cerebral artery (PCA) are uncommon. To date, a limited number of studies have examined the outcomes of endovascular treatment for PCA aneurysms. The authors' aim in this study is to report their experience with the endovascular treatment of PCA aneurysms. METHODS Between January 2007 and December 2014, 55 patients with 59 PCA aneurysms were treated using the endovascular approach at the authors' institution. Twenty-three patients had 25 saccular aneurysms, and 32 patients had 34 fusiform/dissecting aneurysms. The endovascular modalities included the following: 1) selective occlusion of the aneurysm (n = 22); 2) complete occlusion of the aneurysm and the parent artery (n = 20); 3) parent artery occlusion (n = 6); 4) partial coiling of the aneurysm and the parent artery (n = 5); and 5) occlusion of the dissecting aneurysm sac (n = 2). RESULTS The immediate angiographic results included 45 complete occlusions (82%), 2 nearly complete occlusions (4%), and 8 incomplete occlusions (14%). The mean follow-up period of 21.8 months in 46 patients showed 37 stable results, 6 further thromboses, and 3 recurrences. The final results included 41 complete occlusions (89%), 2 nearly complete occlusions (4%), and 3 incomplete occlusions (7%). Procedure-related complications included the following: 1) rebleeding (n = 1); 2) infarction (n = 4); and 3) perforation (n = 1). There was 1 (1.8%) procedure-related death due to rebleeding, and 2 (3.6%) non–procedure-related deaths due to severe subarachnoid hemorrhage. Clinical outcomes were excellent (Glasgow Outcome Scale 5) in 47 of 49 patients at the long-term follow-up. CONCLUSIONS PCA aneurysms may be effectively treated by different endovascular approaches with favorable clinical and radiological outcomes. However, patients who present with severe SAH still have an overall poor prognosis. Partial coiling of the aneurysm and the parent artery is an attractive alternative treatment for patients who may not tolerate parent artery occlusion. Further study with a larger case series is necessary for validation of the durability and efficacy of this treatment.

Claude's Syndrome in Association with Posterior Cerebral Artery Stenosis

2003 ◽  
Vol 48 (3) ◽  
pp. 91-92
Author(s):  
T Dhanjal ◽  
M Walters ◽  
N MacMillan
Keyword(s):  
Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Artery Stenosis

Dissecting Aneurysms of the Posterior Cerebral Artery

Neurosurgery ◽  
2012 ◽  
Vol 70 (6) ◽  
pp. 1581-1588 ◽  
Author(s):  
Huan Wang ◽  
Rose Du ◽  
Joel Stary ◽  
Christos Gkogkas ◽  
Dong Kim ◽  
...  
Keyword(s):  
Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Severe Disabilities ◽  
Treatment Modalities ◽  
Deep Coma ◽  
Recent Experience ◽  
Unique Challenge ◽  
Clinical Series ◽  
Dissecting Aneurysms

AbstractBACKGROUND:Posterior cerebral artery (PCA) aneurysms are relatively rare, making up 1% to 2% of all intracranial aneurysms. To date, most clinical series are heterogeneous in nature, with few reports of isolated PCA dissecting aneurysms. Their clinical presentation can vary greatly, and the potential for long-term sequelae during or after treatment remains relatively high.OBJECTIVE:To report our recent experience in 9 consecutive patients with PCA dissecting aneurysms with a discussion of the unique clinical challenges of their evaluation and treatment.METHODS:We conducted a retrospective review of 9 consecutive patients with PCA dissecting aneurysms from November 2003 to February 2010. Their hospital charts and follow-up records were reviewed and summarized.RESULTS:We identified 6 male and 3 female patients ranging in age from 7 months to 69 years (median age, 53 years). None had any associated trauma. Four patients presented with subarachnoid hemorrhage. Three presented with intraventricular and intracerebral hemorrhage. The remaining 2 presented with headache and acute onset of right-sided numbness, respectively. Four underwent endovascular embolization; 2 underwent surgical clipping; and the remaining 3 were managed medically and followed up conservatively. The dissecting aneurysms involved P1 (n = 2), P1-2 junction (n = 1), P2 (n = 4), and P2-3 junction (n = 1). At a mean follow-up of 3 months, 6 patients had excellent functional outcome with modified Rankin Scale score of 0 or 1. The remaining 3 patients who presented in deep coma did poorly (1 died and 2 had severe disabilities).CONCLUSION:PCA dissecting aneurysms pose a unique challenge and have many unresolved issues regarding treatment modalities.

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