Endovascular Treatment of the Posterior Cerebral Artery Aneurysms: Single-Center Experience and a Systematic Review

被引:18
作者
Sturiale, Carmelo Lucio [1 ]
De Waure, Chiara [2 ]
Della Pepa, Giuseppe Maria [1 ]
Calabro, Giovanna Elisa [2 ]
Albanese, Alessio [1 ]
D'Argento, Francesco [3 ]
Fernandez, Eduardo [1 ]
Olivi, Alessandro [1 ]
Puca, Alfredo [1 ]
Pedicelli, Alessandro [3 ]
Marchese, Enrico [1 ]
机构
[1] Univ Cattolica Sacro Cuore, Sch Med, Inst Neurosurg, Rome, Italy
[2] Univ Cattolica Sacro Cuore, Sch Med, Inst Publ Hlth, Rome, Italy
[3] Univ Cattolica Sacro Cuore, Sch Med, Inst BioImaging, Rome, Italy
关键词
Coiling; Endovascular treatment; Parent artery occlusion; Posterior cerebral artery aneurysms; Posterior circulation aneurysms; INTRACRANIAL ANEURYSMS; DETACHABLE COILS; OCCLUSION; CIRCULATION; MANAGEMENT; GIANT;
D O I
10.1016/j.wneu.2016.03.083
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
BACKGROUND: Endovascular treatment of posterior cerebral artery aneurysms is challenging because of the particular features of posterior circulation vessels. We performed a systematic review of the literature, to assess safety and efficacy associated to their endovascular treatment. METHODS: Through a literature search, we identified 20 studies that met our inclusion criteria. We also performed a retrospective analysis of patients treated at our institution during the last 10 years. Demographics, angiographic features, clinical presentation, and outcome were extracted from each study. Data were combined using a random effects model and heterogeneity was assessed by I-2. RESULTS: We retrieved 7 patients from our institutional series and 246 from the literature. Overall, 253/259 patients/aneurysms were included in this study. A selective coiling was performed in 27% of cases, a stent-assisted coiling in 2%, and a parent artery occlusion in 62%. Immediate complete/near-complete occlusion was obtained in 96% of cases and maintained in 90% at follow-up. No differences were observed between ruptured and unruptured aneurysms. Ischemic complications were reported in 15% of cases, although the most frequent was a hemianopsia in 7%; a hemiparesis was reported in only 2% of cases. Mortality was overall 1%. Ischemic complications were more frequent among patients who underwent nonselective treatment (P < 0.01). CONCLUSIONS: Endovascular treatment of posterior cerebral artery aneurysms is associated with increased degree of occlusion and low recurrence rate. However, a parent artery occlusion implies complications, even although most of them are minor events such as hemianopsia.
引用
收藏
页码:154 / 162
页数:9
相关论文
共 28 条
[11]   Endovascular treatment for aneurysms of the posterior cerebral artery: 12 years' experience with 21 cases [J].
Kashiwazaki, Daina ;
Ushikoshi, Satoshi ;
Asano, Takeshi ;
Osanai, Toshiya ;
Kuroda, Satoshi ;
Houkin, Kiyohiro .
ACTA NEUROCHIRURGICA, 2011, 153 (11) :2151-2158
[12]   Outcomes of multidisciplinary treatment for posterior cerebral artery aneurysms [J].
Kim, Yong Bae ;
Lee, Jae Whan ;
Huh, Seung-Kon ;
Kim, Byung Moon ;
Kim, Dong Jun .
CLINICAL NEUROLOGY AND NEUROSURGERY, 2013, 115 (10) :2062-2068
[13]   Endovascular Treatment of Posterior Cerebral Artery Aneurysms [J].
Li, Youxiang ;
Lv, Xianli ;
Jiang, Chuhan ;
Liu, Aihua ;
Wu, Zhongxue .
NEURORADIOLOGY JOURNAL, 2008, 21 (01) :128-136
[14]   Endovascular management of giant intracranial aneurysms of the posterior circulation [J].
Limaye, Uday S. ;
Baheti, Akshay ;
Saraf, Rashmi ;
Shrivastava, Manish ;
Siddhartha, W. .
NEUROLOGY INDIA, 2012, 60 (06) :597-603
[15]   Deliberate Parent Artery Occlusion for Non-Saccular Posterior Cerebral Artery Aneurysms [J].
Liu, L. ;
He, H. ;
Jiang, C. ;
Lv, X. ;
Li, Y. .
INTERVENTIONAL NEURORADIOLOGY, 2011, 17 (02) :159-168
[16]   Endovascular Treatments for Distal Posterior Cerebral Artery Aneurysms [J].
Luo, Qi ;
Wang, Honglei ;
Xu, Kan ;
Yu, Jinlu .
TURKISH NEUROSURGERY, 2012, 22 (02) :141-147
[17]   Parent Artery Occlusion for Intracranial Aneurysms [J].
Lv, X. ;
Li, Y. ;
Jiang, C. ;
Zhang, J. ;
Yang, X. ;
Wu, Z. .
INTERVENTIONAL NEURORADIOLOGY, 2009, 15 (03) :309-315
[18]   Flow-diverter devices in the treatment of intracranial aneurysms: A meta-analysis and systematic review [J].
Lv, Xianli ;
Yang, Hongchao ;
Liu, Peng ;
Li, Youxiang .
NEURORADIOLOGY JOURNAL, 2016, 29 (01) :66-71
[19]   Potential proneness of fetal-type posterior cerebral artery to vascular insufficiency in parent vessel occlusion of distal posterior cerebral artery aneurysms Clinical article [J].
Lv, Xianli ;
Li, Youxiang ;
Yang, Xinjian ;
Jiang, Chuhan ;
Wu, Zhongxue .
JOURNAL OF NEUROSURGERY, 2012, 117 (02) :284-287
[20]   Methodology for clinical practice guidelines for the management of arteriovenous access [J].
Murad, M. Hassan ;
Swiglo, Brian A. ;
Sidawy, Anton N. ;
Ascher, Enrico ;
Montori, Victor M. .
JOURNAL OF VASCULAR SURGERY, 2008, 48 :26S-30S