Traditionally, microsurgical clipping has been the mainstay of treatment for pericallosal artery aneurysms (PAAs). However, this has changed in recent years with advancements in endovascular surgical techniques. We conducted a retrospective cohort study of pericallosal artery aneurysms that underwent endovascular treatment with coiling and flow diversion at our institution. 33 patients with 34 aneurysms were included (25 aneurysms ruptured, 9 unruptured or recurrent). Of the ruptured group, 22 were coiled (88%) and rest treated with flow diversion. Initial angiographic follow up rate was 72% at median of 159 days. Overall recurrence rate was 40% (10/25) at median of 376 days, all among coiled aneurysms. 6 recurrent aneurysms were retreated with further coiling (2) and flow diversion (4). Of the unruptured/recurrent group, 5 were coiled (55%) and remainder treated with flow diversion. Initial angiographic follow up rate was 100% at median of 267 days. Recurrence rate was 22% (2/9), both in coiled aneurysms. Overall, 27 aneurysms were treated with coiling, 9 with flow diversion and 3 with ‘partial’ flow diversion. All aneurysms treated with pipeline flow diversion achieved 100% occlusion. No re-rupture or new rupture was noted in our series. Good clinical outcome (modified Rankin scale, mRS 0–2) was seen in 79% of patients. Our study demonstrates that endovascular coiling for PAAs is associated with a definite rate of recurrence, which has to be monitored with timely angiography. We also demonstrate the excellent effectiveness of flow diversion for PAAs with either presentation.
Disclosures M. Sattur: None. Y. Li: None. E. Almallouhi: None. J. Lena: 2; C; Penumbra Inc., Alameda, California. A. Spiotta: 2; C; Penumbra Inc., Alameda, California.
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