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Clinical Neuroradiology
Published in: Clinical Neuroradiology 3/2015

01-09-2015 | Original Article

Posterior Communicating Artery Compromise in Coil Embolization of Posterior Communicating Artery Aneurysms

Authors: Y. D. Cho, MD, S. C. Jung, MD, C. H. Kim, MD, J. H. Ahn, MD, H.-S. Kang, MD, PhD, J. E. Kim, MD, PhD, M. H. Han, MD, PhD

Published in: Clinical Neuroradiology | Issue 3/2015

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Abstract

Purpose

Whether the posterior communicating artery (PcomA) can be safely compromised during endovascular treatment of a PcomA aneurysm is a matter of debate. Here we present clinical and radiologic outcomes, given this scenario.

Methods

From data prospectively accrued between January 2004 and December 2012, records of 44 patients harboring 46 PcomA aneurysms were retrieved. All had suffered PcomA compromise in the course of endovascular coil embolization. Patients/aneurysms were stratified into those with complete (Group A) and incomplete (Group B) compromise depending on the degree of PcomA flow limitation documented by postembolization ipsilateral internal carotid artery angiography. Clinical and radiologic outcomes were accordingly assessed.

Results

All affected vessels were hypoplastic PcomA variants (PcomA/P1 ratio, ≤ 1.0), with exception of a single dominant PcomA (PcomA/P1 ratio, 1.1). In Group A (23 patients, 23 aneurysms), no PcomA compromise-related infarction was evident, whereas in Group B (21 patients, 23 aneurysms), two ischemic events occurred. One patient suffered thalamic infarction, although patency of the PcomA was adequate in a follow-up angiogram, and another experienced a transient ischemic attack.

Conclusion

Our findings suggest that obstructed flow in hypoplastic PcomA variants during coil embolization of PcomA aneurysms carries no major consequence. However, incomplete compromise of the PcomA may be a source of delayed thromboembolic infarction.
Literature
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Golshani K, Ferrell A, Zomorodi A, Smith TP, Britz GW. A review of the management of posterior communicating artery aneurysms in the modern era. Surg Neurol Int. 2010;1:88.PubMedCentralCrossRefPubMed
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Kang HS, Kwon BJ, Kim JE, Han MH. Preinterventional clopidogrel response variability for coil embolization of intracranial aneurysms: clinical implications. AJNR Am J Neuroradiol. 2010;31:1206–10.CrossRefPubMed
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Cho YD, Lee WJ, Kim KM, Kang HS, Kim JE, Han MH. Stent-assisted coil embolization of posterior communicating artery aneurysms. AJNR Am J Neuroradiol. 2013;34:2171–6.CrossRefPubMed
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Endo H, Sato K, Kondo R, Matsumoto Y, Takahashi A, Tominaga T. Tuberothalamic artery infarctions following coil embolization of ruptured posterior communicating artery aneurysms with posterior communicating artery sacrifice. AJNR Am J Neuroradiol. 2012;33:500–6.CrossRefPubMed
Metadata
Title
Posterior Communicating Artery Compromise in Coil Embolization of Posterior Communicating Artery Aneurysms
Authors
Y. D. Cho, MD
S. C. Jung, MD
C. H. Kim, MD
J. H. Ahn, MD
H.-S. Kang, MD, PhD
J. E. Kim, MD, PhD
M. H. Han, MD, PhD
Publication date
01-09-2015
Publisher
Springer Berlin Heidelberg
Published in
Clinical Neuroradiology / Issue 3/2015
Print ISSN: 1869-1439
Electronic ISSN: 1869-1447
DOI
https://doi.org/10.1007/s00062-014-0308-4

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