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Safety and Long-term Efficacy of Stent-assisted Coiling for the Treatment of Complex Posterior Cerebral Artery Aneurysms

  • Gaici Xue
  • Haishuang Tang
  • Peng Liu
  • Qiao Zuo
  • Pengfei Yang
  • Yu Zhou
  • Qiang Li
  • Yibin Fang
  • Qinghai Huang
  • Bo Hong
  • Yi Xu
  • Rui ZhaoEmail author
  • Jianmin LiuEmail author
Original Article
  • 3 Downloads

Abstract

Objective

To evaluate the safety and long-term efficacy of stent-assisted coiling for the treatment of complex posterior cerebral artery (PCA) aneurysms.

Methods

Angiographic and clinical data of 23 patients harboring 23 complex PCA aneurysms treated with stent-assisted coiling from March 2010 to March 2017 were retrospectively reviewed.

Results

In this study 8 (34.8%) aneurysms were located at the P1 segment, 7 (30.4%) at the junction of P1 and P2 segments (P1-2), and 8 (34.8%) at the P2 segment. The aneurysms were ruptured in 7 cases (30.4%). Thirteen were dissecting in nature, while the other 10 were classical saccular aneurysms. Of the patients, 5 (21.7%) had of history of recent head trauma, immediate angiographic results were Raymond class I in 5 (21.7%) cases, Raymond class II in 8 (34.8%), and Raymond class III in 10 (43.5%). Perioperative complications occurred in one case with occlusion of the PA due to acute in-stent thrombosis without any neurologic deficit at discharge. The last angiographic follow-up (mean 18.7 months) results demonstrated complete aneurysmal occlusion in 20 (87.0%) cases, PA occlusion in 1 (4.3%) and recurrence in 2 (8.7%). Of the two patients with aneurysm recurrence, one was treated by PA occlusion, and the other was treated with two overlapping stents. Clinical follow-up (mean 58.3 months) was available for all 23 patients, 22 (95.7%) patients had good neurologic outcomes (mRS score 0–2), and 1 (4.3%) patient died 7 months after the procedure for unknown reasons.

Conclusion

Stent-assisted coiling for the treatment of complex PCA aneurysms is safe and durable with a relatively low rate of complication and a relatively high rate of complete occlusion at long-term follow-up and is a promising alternative strategy for the reconstruction of the PCA.

Keywords

Posterior cerebral artery Intracranial aneurysm Endovascular treatment Stent Vascular disorders 

Abbreviations

DSA

Digital subtraction angiography

FD

Flow diversion

P1

P1 segment of the posterior cerebral artery

P1–2

Junction of P1 and P2 segments of the posterior cerebral artery

P2

P2 segment of the posterior cerebral artery

PA

Parent artery

PCA

Posterior cerebral artery

Notes

Funding

The present study was supported by the National Natural Science Foundation of China (grant 81671137, 81571126).

Compliance with ethical guidelines

Conflict of interest

G. Xue, H. Tang, P. Liu, Q. Zuo, P. Yang, Y. Zhou, Q. Li, Y. Fang, Q. Huang, B. Hong, Y. Xu, R. Zhao and J. Liu declare that they have no competing interests.

Ethical standards

This study protocol was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. Written informed consent for inclusion in the study was waived by the Institutional Review Board because of the retrospective design of this observational study.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Gaici Xue
    • 1
  • Haishuang Tang
    • 1
  • Peng Liu
    • 1
  • Qiao Zuo
    • 1
  • Pengfei Yang
    • 1
  • Yu Zhou
    • 1
  • Qiang Li
    • 1
  • Yibin Fang
    • 1
  • Qinghai Huang
    • 1
  • Bo Hong
    • 1
  • Yi Xu
    • 1
  • Rui Zhao
    • 1
    Email author
  • Jianmin Liu
    • 1
    Email author
  1. 1.Department of Neurosurgery, Changhai HospitalSecond Military Medical UniversityShanghaiChina

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