Gaici Xue1, Haishuang Tang1, Peng Liu1, Qiao Zuo1, Pengfei Yang1, Yu Zhou1, Qiang Li1, Yibin Fang1, Qinghai Huang1, Bo Hong1, Yi Xu1, Rui Zhao2, Jianmin Liu3. 1. Department of Neurosurgery, Changhai Hospital, Second Military Medical University, 168 Changhai Road, 200433, Shanghai, China. 2. Department of Neurosurgery, Changhai Hospital, Second Military Medical University, 168 Changhai Road, 200433, Shanghai, China. z_ray1979@126.com. 3. Department of Neurosurgery, Changhai Hospital, Second Military Medical University, 168 Changhai Road, 200433, Shanghai, China. chstroke@163.com.
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.
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.