Zhang Yang, Gu Yi, He Yu, Tang Chaojie, Gu Binxian, Li Yongdong, Wang Wu
Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
Quant Imaging Med Surg. 2022 Jan;12(1):354-365. doi: 10.21037/qims-21-17.
Posterior communicating artery (PcomA) aneurysms are more likely to recanalize than anterior communicating artery (AcomA) aneurysms. However, it is still unclear whether the recanalization rate of these aneurysms is a result of involvement from the fetal posterior cerebral artery (fPCA) in PcomA aneurysms and variation of the unilateral A1 segment in AcomA aneurysms. The purpose of this study is to retrospectively evaluate the different recanalization rates between PcomA aneurysms with fPCA and AcomA aneurysms with a variation of the unilateral A1 segment.
We retrospectively collected information regarding 214 patients, each with communicating segment aneurysms between January 2013 and January 2020. Follow-up documentation on clinical and imaging data was comparatively analyzed between variant types, and recanalization rates of the variant and normal types were analyzed by stratification.
Of the 84 variant-type aneurysms (PcomA with fPCA and AcomA with a variation of the unilateral A1 segment, 41/43), complete recanalization occurred in 23 patients (27.4%), and it was significantly more likely to occur in PcomA aneurysms with fPCA (39.1%) than in AcomA aneurysms with a variation of the unilateral A1 segment (16.3%). Stent-assisted coil embolization (SACE) has been shown to reduce recanalization (OR =0.092, 95% CI: 0.011 to 0.790, P=0.03). Additionally, variant types and the normal type (non-fetal, 106, and bilateral A1 symmetry, 24) have different odds ratios (OR) of recanalization (P=0.04), and the OR of the variant subtypes was significant, unlike the normal type (P=0.49).
This study suggests that PcomA aneurysms with fPCA are more likely to recanalize than AcomA aneurysms with a variation of the unilateral A1 segment.
后交通动脉（PcomA）动脉瘤比前交通动脉（AcomA）动脉瘤更易再通。然而，这些动脉瘤的再通率是否是由于PcomA动脉瘤中胎儿型大脑后动脉（fPCA）的累及以及AcomA动脉瘤中单侧A1段的变异所致仍不清楚。本研究的目的是回顾性评估伴有fPCA的PcomA动脉瘤与伴有单侧A1段变异的AcomA动脉瘤之间不同的再通率。
我们回顾性收集了2013年1月至2020年1月期间214例患有交通段动脉瘤患者的信息。对不同变异类型的临床和影像数据随访记录进行对比分析，并对变异型和正常型的再通率进行分层分析。
在84例变异型动脉瘤（伴有fPCA的PcomA和伴有单侧A1段变异的AcomA，41/43）中，23例患者（27.4%）出现完全再通，伴有fPCA的PcomA动脉瘤（39.1%）比伴有单侧A1段变异的AcomA动脉瘤（16.3%）更易发生完全再通。支架辅助弹簧圈栓塞（SACE）已被证明可降低再通率（OR =0.092，95%CI：0.011至0.790，P =0.03）。此外，变异型与正常型（非胎儿型，106例，双侧A1对称，24例）的再通比值比（OR）不同（P =0.04），且变异型亚型的OR具有显著性，与正常型不同（P =0.49）。
本研究表明，伴有fPCA的PcomA动脉瘤比伴有单侧A1段变异的AcomA动脉瘤更易再通。
