Department of Neurosurgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea, Seoul, The Republic of Korea.
Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, The Republic of Korea.
J Neurointerv Surg. 2019 Aug;11(8):790-795. doi: 10.1136/neurintsurg-2018-014490. Epub 2019 Jan 17.
Recanalization rates after coil embolization are known to be higher in cerebral aneurysms of the posterior (vs anterior) circulation. Although often grouped with anterior lesions, aneurysms of the posterior communicating artery (PcoA) may nevertheless behave differently.
We performed a comparative analysis to explore differences in recanalization rates of PcoA and anterior communicating artery (AcoA) aneurysms, both integral to the circle of Willis.
Between October 2012 and July 2017, 699 AcoA (n=427) and PcoA (n=272) aneurysms were treated by endovascular coil embolization, monitoring 667 (95.4%) via radiologic imaging for ≥ 6 months. Cumulative recordings of medical and imaging data were retrospectively reviewed, conducting propensity score matching and binary logistic regression analysis.
In the 667 aneurysms followed longer term, recanalization occurred in 111 (16.6%; minor 72; major 39) and was significantly more frequent in PcoA (25.5%) than in AcoA (11.0%; P<0.01) aneurysms during similar follow-up periods. After 1:1 propensity score matching, an even greater proclivity for recanalization was evident at PcoA sites (PcoA 23.0%; AcoA 12.2%; P<0.01). Although A1 segment dominance was linked to recanalization in AcoA aneurysms (18.2% vs 7.6%; P=0.01), the PcoA counterpart had no bearing on recanalization (27.7% vs 24.1%; P=0.51).
Despite a clear preponderance of AcoA aneurysms, recanalization of PcoA aneurysms proved significantly greater, attesting to posterior circulation behavior.
已知颅内后循环（相对于前循环）动脉瘤在进行线圈栓塞后再通率更高。尽管后交通动脉瘤（PcoA）通常与前交通动脉瘤一起分组，但它们的行为可能不同。
我们进行了一项对比分析，以探讨后交通动脉瘤（PcoA）和前交通动脉瘤（AcoA）的再通率差异，两者都是 Willis 环的组成部分。
在 2012 年 10 月至 2017 年 7 月期间，通过血管内线圈栓塞治疗了 699 例 AcoA（n=427）和 PcoA（n=272）动脉瘤，对 667 例（95.4%）进行了≥6 个月的放射影像学监测。回顾性回顾了医疗和影像学数据的累积记录，并进行了倾向评分匹配和二元逻辑回归分析。
在随访时间较长的 667 例动脉瘤中，111 例（16.6%；小 72 例；大 39 例）发生再通，PcoA（25.5%）明显高于 AcoA（11.0%）（P<0.01）。在相似的随访期间。在 1:1 倾向评分匹配后，PcoA 部位的再通倾向更加明显（PcoA 23.0%；AcoA 12.2%；P<0.01）。尽管 A1 段优势与 AcoA 动脉瘤的再通有关（18.2%对 7.6%；P=0.01），但 PcoA 对应的部位与再通无关（27.7%对 24.1%；P=0.51）。
尽管 AcoA 动脉瘤明显占优势，但 PcoA 动脉瘤的再通率明显更高，证明了后循环的行为。
