Evaluation of Radiological Features of the Posterior Communicating Artery and their Impact on Efficacy of Saccular Aneurysm Treatment with the Pipeline Embolization Device: A Case Series Study.

Evaluation of Radiological Features of the Posterior Communicating Artery and their Impact on Efficacy of Saccular Aneurysm Treatment with the Pipeline Embolization Device: A Case Series Study.

World Neurosurg. 2019 Feb 13;:

Authors: Enriquez-Marulanda A, Ravindran K, Salem MM, Ascanio LC, Kan P, Srinivasan VM, Griessenauer CJ, Schirmer CM, Jain A, Moore JM, Ogilvy CS, Thomas AJ, Alturki AY

Abstract
BACKGROUND AND PURPOSE: Posterior communicating artery segment aneurysms are one of the most frequent intracranial aneurysms. Currently, there is limited literature describing the use of the pipeline embolization device in these aneurysms.
MATERIAL AND METHODS: We conducted a multicenter retrospective review of 3 prospectively-collected databases of patients treated with pipeline between January 2013 and December 2017. The primary objective was to assess the efficacy and safety of the pipeline in the treatment of saccular posterior communicating artery aneurysms. We also assessed the impact of anatomical variations on angiographic and clinical outcomes, including the presence of fetal posterior communicating artery, the vessel origin relationship to the aneurysm, and patency following pipeline placement.
RESULTS: We identified 57 patients with 60 saccular aneurysms; Mean age was 60.5 years, and 49 (86.0%) patients were female. A total of 55 (91.7%) aneurysms were unruptured. Median imaging last follow-up was 8.5 months. Complete occlusion at last imaging follow-up was 84.0%. At last follow-up, 94.5% of patients had an mRS≤2. Presence of fetal posterior communicating artery, type of origin, and patency on follow-up were not found to have a significant impact on aneurysm occlusion (p=0.61, p=0.40, and p=0.14, respectively).
CONCLUSION: Pipeline treatment of posterior communicating artery aneurysms results in acceptable occlusion rates. This study did not find that the presence of fetal posterior communicating artery, its origin, and its patency on follow-up to have an impact on aneurysm occlusion.

PMID: 30771544 [PubMed - as supplied by publisher]

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