共 28 条
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