Comparative analysis of coil embolization in posterior and anterior communicating artery aneurysms.
Adult
Aged
Anterior Cerebral Artery
/ diagnostic imaging
Blood Vessel Prosthesis
Cerebral Angiography
/ methods
Circle of Willis
/ diagnostic imaging
Embolization, Therapeutic
/ methods
Female
Humans
Intracranial Aneurysm
/ diagnostic imaging
Male
Middle Aged
Posterior Cerebral Artery
/ diagnostic imaging
Retrospective Studies
Treatment Outcome
aneurysm
coil
hemorrhage
Journal
Journal of neurointerventional surgery
ISSN: 1759-8486
Titre abrégé: J Neurointerv Surg
Pays: England
ID NLM: 101517079
Informations de publication
Date de publication:
Aug 2019
Aug 2019
Historique:
received:
10
10
2018
revised:
09
12
2018
accepted:
11
12
2018
pubmed:
19
1
2019
medline:
31
10
2019
entrez:
19
1
2019
Statut:
ppublish
Résumé
Recanalization rates after coil embolization are known to be higher in cerebral aneurysms of the posterior (vs anterior) circulation. Although often grouped with anterior lesions, aneurysms of the posterior communicating artery (PcoA) may nevertheless behave differently. We performed a comparative analysis to explore differences in recanalization rates of PcoA and anterior communicating artery (AcoA) aneurysms, both integral to the circle of Willis. Between October 2012 and July 2017, 699 AcoA (n=427) and PcoA (n=272) aneurysms were treated by endovascular coil embolization, monitoring 667 (95.4%) via radiologic imaging for ≥ 6 months. Cumulative recordings of medical and imaging data were retrospectively reviewed, conducting propensity score matching and binary logistic regression analysis. In the 667 aneurysms followed longer term, recanalization occurred in 111 (16.6%; minor 72; major 39) and was significantly more frequent in PcoA (25.5%) than in AcoA (11.0%; P<0.01) aneurysms during similar follow-up periods. After 1:1 propensity score matching, an even greater proclivity for recanalization was evident at PcoA sites (PcoA 23.0%; AcoA 12.2%; P<0.01). Although A1 segment dominance was linked to recanalization in AcoA aneurysms (18.2% vs 7.6%; P=0.01), the PcoA counterpart had no bearing on recanalization (27.7% vs 24.1%; P=0.51). Despite a clear preponderance of AcoA aneurysms, recanalization of PcoA aneurysms proved significantly greater, attesting to posterior circulation behavior.
Sections du résumé
BACKGROUND
BACKGROUND
Recanalization rates after coil embolization are known to be higher in cerebral aneurysms of the posterior (vs anterior) circulation. Although often grouped with anterior lesions, aneurysms of the posterior communicating artery (PcoA) may nevertheless behave differently.
OBJECTIVE
OBJECTIVE
We performed a comparative analysis to explore differences in recanalization rates of PcoA and anterior communicating artery (AcoA) aneurysms, both integral to the circle of Willis.
METHODS
METHODS
Between October 2012 and July 2017, 699 AcoA (n=427) and PcoA (n=272) aneurysms were treated by endovascular coil embolization, monitoring 667 (95.4%) via radiologic imaging for ≥ 6 months. Cumulative recordings of medical and imaging data were retrospectively reviewed, conducting propensity score matching and binary logistic regression analysis.
RESULTS
RESULTS
In the 667 aneurysms followed longer term, recanalization occurred in 111 (16.6%; minor 72; major 39) and was significantly more frequent in PcoA (25.5%) than in AcoA (11.0%; P<0.01) aneurysms during similar follow-up periods. After 1:1 propensity score matching, an even greater proclivity for recanalization was evident at PcoA sites (PcoA 23.0%; AcoA 12.2%; P<0.01). Although A1 segment dominance was linked to recanalization in AcoA aneurysms (18.2% vs 7.6%; P=0.01), the PcoA counterpart had no bearing on recanalization (27.7% vs 24.1%; P=0.51).
CONCLUSIONS
CONCLUSIONS
Despite a clear preponderance of AcoA aneurysms, recanalization of PcoA aneurysms proved significantly greater, attesting to posterior circulation behavior.
Identifiants
pubmed: 30655359
pii: neurintsurg-2018-014490
doi: 10.1136/neurintsurg-2018-014490
doi:
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
790-795Informations de copyright
© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.