Department of Neurosurgery, Changhai Hospital, Navy Military Medical University, Shanghai, 200433, People's Republic of China.
Naval Medical Center of PLA, Navy Military Medical University, Shanghai, 200050, People's Republic of China.
Neuroradiology. 2022 Sep;64(9):1847-1856. doi: 10.1007/s00234-022-02956-3. Epub 2022 Apr 20.
Posterior cerebral artery (PCA) aneurysms are rare. This study is to evaluate the preliminary experience of braided stents applied in PCA aneurysms treatment.
Angiographic and clinical data of 28 PCA patients treated with braided stents from July 2016 and September 2020 were retrospectively analyzed.
A total of 28 PCA aneurysms were enrolled. 22 (78.6%) aneurysms were dissecting aneurysms, while 6 (21.4%) aneurysms were saccular aneurysms. Thirty-five braided stents were implanted with dual stents implanted in 7 cases. Immediate angiographic results show that Raymond class I was obtained in 13 patients (46.4%), Raymond class II was obtained in 4 patients (14.3%), and Raymond class III was obtained in 11 patients (39.3%). Perioperative hemorrhagic events occurred in 1 patient (3.6%). Twenty-four patients (85.7%) received angiographic follow-up, and the mean follow-up time was 11.2 ± 4.9 months. Two patients (8.3%) were confirmed with IA neck recurrence, and 3 patients (12.5%) were confirmed asymptomatic parent artery occlusion (PAO). The other 19 patients were confirmed promoted occlusion with 18 Raymond class I (75%) and 1 Raymond class II (4.2%). Twenty-seven patients (96.4%) received clinical follow-up, and the mean follow-up time was 32.2 ± 13.5 months. One patient (3.7%) confirmed the death event 2 weeks after discharge. The other 27 patients (96.3%) got favorable clinical outcomes with an mRS score of 0-2.
Braided stent-assisted coiling with a high occlusion rate and relatively low complication rate provides an alternative strategy in treating PCA aneurysms. Long-term outcomes need further randomized study with larger case numbers.
大脑后动脉（PCA）动脉瘤较为罕见。本研究旨在评估编织支架在 PCA 动脉瘤治疗中的初步应用经验。
回顾性分析 2016 年 7 月至 2020 年 9 月期间接受编织支架治疗的 28 例 PCA 患者的血管造影和临床资料。
共纳入 28 个 PCA 动脉瘤，其中 22 个（78.6%）为夹层动脉瘤，6 个（21.4%）为囊状动脉瘤。7 例患者植入双支架，共植入 35 枚编织支架。即刻血管造影结果显示，13 例（46.4%）患者达到 Raymond Ⅰ级，4 例（14.3%）患者达到 Raymond Ⅱ级，11 例（39.3%）患者达到 Raymond Ⅲ级。1 例（3.6%）患者发生围手术期出血事件。24 例（85.7%）患者接受了血管造影随访，平均随访时间为 11.2±4.9 个月。2 例（8.3%）患者确认 IA 瘤颈再发，3 例（12.5%）患者确认无症状的载瘤动脉闭塞（PAO）。其余 19 例患者确认得到促进闭塞，其中 18 例达到 Raymond Ⅰ级（75%），1 例达到 Raymond Ⅱ级（4.2%）。27 例（96.4%）患者接受了临床随访，平均随访时间为 32.2±13.5 个月。1 例（3.7%）患者在出院后 2 周时确认死亡事件。其余 27 例（96.3%）患者的 mRS 评分 0-2 分，预后良好。
编织支架辅助弹簧圈栓塞治疗 PCA 动脉瘤具有较高的闭塞率和相对较低的并发症发生率，为该疾病的治疗提供了一种替代策略。需要进一步进行更大样本量的随机研究以获得长期结果。
