Angiographic characteristics and endovascular treatment of posterior communicating aneurysms: A single-center experience

Numerous issues related to the endovascular treatment of posterior communicating artery (PcomA) aneurysms require further investigation, including preservation versus sacrifice of the PcomA, the choice to stent the artery, the feasibility of flow diverter (FD) deployment, and the factors affecting PcomA aneurysm occlusion and recurrence. We conducted this study to address these issues. The affected PcomAs were divided into 5 grades on the basis of their development, while PcomA aneurysms were divided into types 1 through 4. The data were statistically analyzed. A total of 220 patients (mean age 59.8 ± 9.8 years) with 233 PcomA aneurysms were enrolled in this study. Among all the aneurysms, 202 (86.7%, 202/233) were treated with coiling, and 31 (13.3%, 31/233) were treated with an FD. The follow-up time was 7.1 ± 2.2 months. The modified Rankin scale score ranged from 0 to 2 for 97.2% of the patients. According to the modified Raymond-Roy classification, 98.5% of the coiled aneurysms were class I or II at the follow-up assessment. The follow-up O'Kelly Marotta grade was C-D in 89.7% of PcomA aneurysms treated with FD deployment. Our study revealed that small PcomA aneurysms, nonfetal-type PcomA aneurysms, and PcomA stenting tended to be associated with a greater rate of aneurysm occlusion after coiling. PcomA compromise appears to be safe if the PcomA is hypoplastic. Traditional coiling can still achieve good clinical and angiographic outcomes for PcomA aneurysms, while FD deployment can serve as an alternative to coiling for these aneurysms.