Abstract
BackgroundThe aim of this study was to retrospectively analyze our experience with the patients who underwent surgical treatment of posterior communicating artery (PComA) aneurysms originating from fetal posterior cerebral artery (fPCA) and analyze the risk factors for the postoperative radiological infarction and outcome.MethodsFrom 2011 to 2020, we retrospectively reviewed 74 PComA aneurysms originating from fPCA in terms of the clinical and radiological features and obtained the follow-up data from the Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University. The relationships between these features and follow-up data were assessed with the univariate and multivariate analysis.ResultsIn this series, 74 aneurysms were occurring at the origin of fPCAs. All the patients showed complete obliteration of their aneurysms. Full fPCA type tends to be a predictive factor for radiological infarction (univariate χ2 = 5.873, P = 0.027; multivariate OR = 0.264, P = 0.060). Postoperative radiological infarction (univariate χ2 = 12.611, P = 0.001; multivariate OR = 6.033, P = 0.043), rupture (univariate χ2 = 4.514, P = 0.047; multivariate OR = 57.966, P = 0.044), and hypertension (univariate χ2 = 5.301, P = 0.024; multivariate OR = 24.462, P = 0.029) tend to be the independent predictive factors for poor prognosis at 3 months after discharge.ConclusionsIn conclusion, we report a series of patients harboring aneurysms originating from the fPCA. Surgical clipping is a reliable strategy. Full fPCA type is related to postsurgical infarction. Postoperative radiological infarction, rupture, and hypertension tend to be the independent predictive factor for poor prognosis at 3 months after discharge.
Highlights
The aim of this study was to retrospectively analyze our experience with the patients who underwent surgical treatment of posterior communicating artery (PComA) aneurysms originating from fetal posterior cerebral artery and analyze the risk factors for the postoperative radiological infarction and outcome
Seventeen patients (23.0%) had multiple aneurysms on preoperative angiography
The binary logistic regression analysis revealed that postoperative radiological infarction (odds ratio (OR) = 6.033, 95% confidence interval (CI) (1.057–34.437), P = 0.043), rupture (OR = 57.966, 95% Confidence interval (CI) (1.112–3020.66), P = 0.044), and hypertension (OR = 24.462, 95% CI (1.385–431.917), P = 0.029) are the potential independent predictive factors (Table 3)
Summary
The aim of this study was to retrospectively analyze our experience with the patients who underwent surgical treatment of posterior communicating artery (PComA) aneurysms originating from fetal posterior cerebral artery (fPCA) and analyze the risk factors for the postoperative radiological infarction and outcome. Either surgical clipping or endovascular obliteration of PComA aneurysms has a big chance to inadvertently injury the PComA itself or adjacent perforating arteries, leading to ischemic injury to dependent regions [9, 10]. There were only few reports referring to surgical experiences about the fPCA aneurysms. The risk factors for the outcomes of surgical treatment for fPCA aneurysms have not been evaluated yet. The aim of this study was to retrospectively report our surgical experience with a series of 74 fPCA aneurysm patients in our institution and analyze the risk factors for the outcome
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