Zhang Wengao, Li Gang, Wang Xirui, Gao Yue, Gao Pengfei, Wang Bangyue
Department of Neurosurgery, Cangzhou Central Hospital, Cangzhou, Hebei, China.
Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China.
World Neurosurg. 2025 Feb;194:123532. doi: 10.1016/j.wneu.2024.11.115. Epub 2024 Dec 24.
Posterior cerebral artery (PCA) aneurysms are rare but clinically significant due to their critical location and complex management. The risk factor of the PCA aneurysms rupture remains unclear. This study aimed to investigate the associated factor of PCA aneurysms rupture in a large Chinese cohort.
We conducted a cross-sectional study including patients diagnosed with PCA aneurysms between January 2017 and December 2020. The study population comprised 143 patients, with 95 in the ruptured group and 48 in the unruptured group. Data on demographic characteristics, aneurysm features, medical history, and treatment outcomes were collected and analyzed using SPSS 27.0. Univariate and multivariate logistic regression analyses were performed to identify associated factors for PCA aneurysm rupture.
The presence of coexisting internal carotid artery occlusion (ICAO) was identified as an independent associated factor for PCA aneurysm rupture (odds ratio [OR] = 4.74, 95% confidence interval [CI] 1.22-18.42, P = 0.03). Ischemic stroke (OR=0.44, 95% CI: 0.20-0.97, P = 0.02) and multiple aneurysms (OR=0.41, 95% CI: 0.19-0.87, P = 0.04) were found to be potential protective factors against rupture. The study also revealed a higher incidence of ICAO in the ruptured group (18.9%) compared to the unruptured group (6.3%), indicating a significant association with aneurysm rupture.
This is the first multicenter study to highlight the coexistence of ICAO as a major associated factor for PCA aneurysm rupture in the Chinese population.
大脑后动脉（PCA）动脉瘤虽罕见，但因其位置关键且治疗复杂，具有临床重要性。PCA动脉瘤破裂的危险因素尚不清楚。本研究旨在调查一个大型中国队列中PCA动脉瘤破裂的相关因素。
我们进行了一项横断面研究，纳入2017年1月至2020年12月期间诊断为PCA动脉瘤的患者。研究人群包括143例患者，其中破裂组95例，未破裂组48例。收集人口统计学特征、动脉瘤特征、病史和治疗结果的数据，并使用SPSS 27.0进行分析。进行单因素和多因素逻辑回归分析以确定PCA动脉瘤破裂的相关因素。
颈内动脉闭塞（ICAO）并存被确定为PCA动脉瘤破裂的独立相关因素（比值比[OR]=4.74，95%置信区间[CI]1.22-18.42，P=0.03）。缺血性卒中（OR=0.44，95%CI：0.20-0.97，P=0.02）和多发动脉瘤（OR=0.41，95%CI：0.19-0.87，P=0.04）被发现是防止破裂的潜在保护因素。研究还显示，破裂组的ICAO发生率（18.9%）高于未破裂组（6.3%），表明与动脉瘤破裂存在显著关联。
这是第一项多中心研究，强调了ICAO并存是中国人群中PCA动脉瘤破裂的主要相关因素。
