Liu Jian, Zhang Ying, Li Wenqiang, Wang Kun, Zhang Yisen, Yang Xinjian
Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tian Tan Hospital, Capital Medical University, Beijing, China.
Interv Neuroradiol. 2020 Feb;26(1):55-60. doi: 10.1177/1591019919874603. Epub 2019 Sep 5.
The true posterior communicating artery (TPCoA) aneurysms are rare and endovascular treatment for such lesions is limited in literature.
From January 2012 to March 2017, eight TPCoA aneurysms were treated endovascularly and included in our present study. The procedural complication and outcomes were assessed.
Seven of eight aneurysms (87.5%) were ruptured. Stent-assisted coiling was used in one case that a stent was deployed via PCoA-ipsilateral P2 segment. The dual-microcatheter technique was used in one case. The remaining six cases were treated by coiling alone. One patient (12.5%) suffered perioperative complication, of which a coil herniated into parent vessel during the procedure without symptomatic stroke or other adverse event after the procedure. The initial embolization results showed complete occlusion in five cases and residual neck in three. Six patients (75%) had a mean of 15-month angiographic follow-up and two of them revealed recurrence (33.3%). Clinical follow-up was available in seven patients (87.5%) and all patients showed favorable clinical outcome with mRS score 0.
TPCoA aneurysms are rare and challenging lesions with high rupture rate in literatures. Endovascular treatment may be a feasible alternative for TPCoA aneurysms. Primary coiling, as well as adjunctive strategies, such as stent-assisted coiling or dual catheter techniques may be considered. Further study in a larger population is necessary.
真正的后交通动脉（TPCoA）动脉瘤较为罕见，关于此类病变的血管内治疗在文献中的报道有限。
2012年1月至2017年3月期间，对8例TPCoA动脉瘤进行了血管内治疗，并纳入本研究。评估手术并发症及治疗结果。
8例动脉瘤中有7例（87.5%）破裂。1例通过经后交通动脉同侧P2段置入支架，采用支架辅助弹簧圈栓塞治疗。1例采用双微导管技术。其余6例仅行弹簧圈栓塞治疗。1例患者（12.5%）出现围手术期并发症，术中1枚弹簧圈疝入载瘤血管，但术后未出现症状性卒中或其他不良事件。初始栓塞结果显示5例完全闭塞，3例有残余瘤颈。6例患者（75%）平均接受了15个月的血管造影随访，其中2例复发（33.3%）。7例患者（87.5%）获得临床随访，所有患者临床结局良好，改良Rankin量表（mRS）评分为0分。
TPCoA动脉瘤罕见且具有挑战性，文献报道其破裂率高。血管内治疗可能是TPCoA动脉瘤的一种可行替代方案。可考虑采用单纯弹簧圈栓塞以及支架辅助弹簧圈栓塞或双导管技术等辅助策略。有必要在更大规模人群中开展进一步研究。
