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  • Impact of fetal-type posterior cerebral artery on recanalization of posterior communicating artery aneurysms after coil embolization: matched-pair case–control study

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Hemorrhagic Stroke
Original research
Impact of fetal-type posterior cerebral artery on recanalization of posterior communicating artery aneurysms after coil embolization: matched-pair case–control study
  1. Hyun Ho Choi1,
  2. Young Dae Cho2,
  3. Dong Hyun Yoo2,
  4. Heui Seung Lee2,
  5. Sung-Hyun Kim2,
  6. Donghwan Jang3,
  7. Sung Ho Lee3,
  8. Won-Sang Cho3,
  9. Hyun-Seung Kang3,
  10. Jeong Eun Kim3
  1. 1 Department of Neurosurgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea
  2. 2 Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
  3. 3 Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
  1. Correspondence to Dr Young Dae Cho, Radiology, Seoul National University Boramae Hospital, Seoul 110-744, Republic of Korea; aronnn{at}naver.com

Abstract

Background It is well known that hemodynamic stress may impact the recanalization of coiled aneurysms. One of the most common sites for aneurysms to develop is the posterior communicating artery (PcoA), the variants of which are defined by diameter ratios (PcoA/P1 segment).

Objective This study was undertaken to investigate the impact of a fetal-type posterior cerebral artery (PCA) on recanalization of PcoA aneurysms after coil embolization based on matched-pair (fetal vs non-fetal PCA) analysis.

Methods A total of 480 consecutive PcoA aneurysms (PCA: fetal, n=156; non-fetal, n=324) subjected to coil embolization between January 2007 and June 2017 were selected for study. All lesions were followed for ≥6 months via radiologic imaging, grouped by adjacent PCAs as fetal (PcoA/P1 >1) or non-fetal (PcoA/P1 ≤1) type. Paired subjects were matched (1:1) for several relevant variables.

Results Of the 480 coiled aneurysms, 159 (33.1%) showed recanalization (minor, 76; major, 83) in the course of follow-up (mean 33.8±21.9 months), developing significantly more often in fetal (37.8%) than in non-fetal (26.9%; p=0.020) PCA types. Once matched, however, 6-month and cumulative recanalization rates did not differ significantly by group (p=0.531 and p=0.568, respectively). Complications (hemorrhage, p=0.97; thromboembolism, p=0.94) during endovascular coil embolization also showed similar rates in these groups.

Conclusions The chances of recanalization after coil embolization seem to be greater in PcoA aneurysms than in intracranial aneurysms overall, thus calling for careful follow-up monitoring. Surprisingly, PcoA type appeared unrelated in this regard.

  • aneurysm
  • coil

https://doi.org/10.1136/neurintsurg-2019-015531

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    Footnotes

    • Contributors HHC conceived and conducted the review of this series, analyzed the data, drafted and revised the manuscript, and approved the final version. DHY, HSL, S-HK, DJ, SHL, W-SC, H-SK, and JEK performed the operations, assisted in conducting the review of the series, revised the manuscript, and approved the final draft. YDC conceived and conducted the project, performed the operations, analyzed the data, revised the manuscript, and approved the final draft.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval H-1908-180-1060.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data sharing not applicable as no datasets generated and/or analysed for this study.