Clinical observation of endovascular treatment of posterior cerebral artery aneurysms

Objective To investigate the safety and efficacy of endovascular treatment of posterior cerebral artery (PCA) aneurysms. Methods The clinical data of 27 patients with PCA aneurysm treated with endovascular treatment at the Department of Neurosurgery, Changhai Hospital, the Second Military Medical University from September 1998 to December 2009 were collected. The methods and efficacy of endovascular treatment were analyzed retrospectively. Results All patients underwent endovascular treatment. The aneurysms of 4 patients embolized alone were packed densely (aneurysm at P2 segment), and the parent arteries were patent; 3 patients underwent parent artery occlusion alone (aneurysm at P2 segment), the aneurysms and the distal end of parent arteries did not develop. One patient performed stenting alone (at P1 segment), 1 performed stent-assisted coil embolization (at the junction of P1-P2), his aneurysms did not develop, and his parent artery was patent; 18 patients performed aneurysm embolization + parent artery occlusion (1 case at P1 segment, 11 at P2 segment, 2 at the junction of P2-P3 segments, 4 at P3 segment), including 17 performed aneurysm dense packing + parent artery occlusion, and one performed loose aneurysm embolization + parent artery occlusion. Of the 21 patients (77.8%) occluded parent arteries, 5 (23.8%) occurred ischemic events in the occluded blood supply area, and 4 (19.0%) were cerebral infarction. Twenty-three patients were followed up clinically, the follow-up time ranged from 1 month to 5 years, and 2 died. Six patients performed MR angiography (MRA) examination, 12 performed DSA examination, 3 had aneurysm recurrence, and after being treated again, they were cured during the follow-up period. Other patients recovered well. Conclusions As for the aneurysm at P1 segment, the embolization of aneurysm and maintaining parent artery patency are the main objectives. The P2 segment and the distal aneurysms should be packed densely. At the same time, the parent artery should be occluded exactly. Endovascular treatment of PCA aneurysms is safe and effective. Key words: Intracranial aneurysm; Posterior cerebral artery; Endovascular procedures