Results of surgical management for posterior cerebral artery aneurysms: 7-year experience in the endovascular era.
OBJECTIVE
Unlike most posterior circulation aneurysms, posterior cerebral artery (PCA) aneurysms can be surgically approached, we believe, without significant technical difficulty or procedural morbidity. We report our recent experience to assess procedural complications and clinical outcomes for PCA aneurysms.


METHODS
In our retrospective review of 15 consecutive patients with PCA aneurysms, six patients underwent surgical treatment, six patients had endovascular coiling, (three patients from the endovascular group also underwent surgical revascularization), and three patients were treated conservatively (medical or observation) (2001-2007). Clinical records were reviewed for: patient demographics; clinical presentation; aneurysm location, size, and morphology; treatment; procedural complications; outcome (clinical and angiographic).


RESULTS
Complete aneurysm obliteration with parent vessel or bypass patency was demonstrated by intraoperative angiography in all patients. One patient died and two patients suffered procedure-related permanent neurologic injury. Considering both surgical end endovascular treatment modalities, mortality was 8.3% and permanent morbidity was 16.6%. At mean clinical follow-up of 2-96 months (15.8 +/- 10.5 months), nine of ten patients had a Glasgow Outcome Score of 4 or 5. In patients who underwent bypass procedures, computed tomographic (CT) angiography or cerebral angiography demonstrated a patent functional bypass before the PCA occlusion.


CONCLUSIONS
Our findings for these 15 patients suggest the value of a multimodality of treatments for PCA aneurysms. Revascularization of the PCA can be performed with favorable technical results and clinical outcomes when the patency of the PCA cannot be preserved.
Kocaeli
Hasan
H
Department of Neurosurgery, University of Cincinnati Neuroscience Institute and UC College of Medicine, OH, USA.
Chaalala
Chiraz
C
Abruzzo
Todd A
TA
Zuccarello
Mario
M
D002985:Clinical Protocols; D004621:Embolization, Therapeutic / Q000379:methods / Q000401:mortality / Q000639:trends*; D023261:Glasgow Outcome Scale; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D018579:Patient Selection; D020769:Posterior Cerebral Artery / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000401:mortality; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods / Q000401:mortality / Q000639:trends*