title: Endovascular Treatment of the Posterior Cerebral Artery Aneurysms: Single-Center Experience and a Systematic Review.
abstract: BACKGROUND
  Endovascular treatment of posterior cerebral artery aneurysms is challenging because of the particular features of posterior circulation vessels. We performed a systematic review of the literature, to assess safety and efficacy associated to their endovascular treatment.
  
  
  METHODS
  Through a literature search, we identified 20 studies that met our inclusion criteria. We also performed a retrospective analysis of patients treated at our institution during the last 10 years. Demographics, angiographic features, clinical presentation, and outcome were extracted from each study. Data were combined using a random effects model and heterogeneity was assessed by I(2).
  
  
  RESULTS
  We retrieved 7 patients from our institutional series and 246 from the literature. Overall, 253/259 patients/aneurysms were included in this study. A selective coiling was performed in 27% of cases, a stent-assisted coiling in 2%, and a parent artery occlusion in 62%. Immediate complete/near-complete occlusion was obtained in 96% of cases and maintained in 90% at follow-up. No differences were observed between ruptured and unruptured aneurysms. Ischemic complications were reported in 15% of cases, although the most frequent was a hemianopsia in 7%; a hemiparesis was reported in only 2% of cases. Mortality was overall 1%. Ischemic complications were more frequent among patients who underwent nonselective treatment (P < 0.01).
  
  
  CONCLUSIONS
  Endovascular treatment of posterior cerebral artery aneurysms is associated with increased degree of occlusion and low recurrence rate. However, a parent artery occlusion implies complications, even although most of them are minor events such as hemianopsia.
authors.affiliation: Institute of Neurosurgery, Catholic University School of Medicine, Rome, Italy. Electronic address: cropcircle.2000@virgilio.it.
authors.forename: Carmelo Lucio
authors.initials: CL
authors.lastname: Sturiale
authors.affiliation: Institute of Public Health, Catholic University School of Medicine, Rome, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: De Waure
authors.affiliation: Institute of Neurosurgery, Catholic University School of Medicine, Rome, Italy.
authors.forename: Giuseppe Maria
authors.initials: GM
authors.lastname: Della Pepa
authors.affiliation: Institute of Public Health, Catholic University School of Medicine, Rome, Italy.
authors.forename: Giovanna Elisa
authors.initials: GE
authors.lastname: Calabrò
authors.affiliation: Institute of Neurosurgery, Catholic University School of Medicine, Rome, Italy.
authors.forename: Alessio
authors.initials: A
authors.lastname: Albanese
authors.affiliation: Institute of BioImaging, Catholic University School of Medicine, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: D'Argento
authors.affiliation: Institute of Neurosurgery, Catholic University School of Medicine, Rome, Italy.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Fernandez
authors.affiliation: Institute of Neurosurgery, Catholic University School of Medicine, Rome, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Olivi
authors.affiliation: Institute of Neurosurgery, Catholic University School of Medicine, Rome, Italy.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Puca
authors.affiliation: Institute of BioImaging, Catholic University School of Medicine, Rome, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Pedicelli
authors.affiliation: Institute of Neurosurgery, Catholic University School of Medicine, Rome, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Marchese
mesh_terms: D017542:Aneurysm, Ruptured / Q000628:therapy*; D002545:Brain Ischemia / Q000453:epidemiology* / Q000209:etiology; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000706:statistics & numerical data*; D057510:Endovascular Procedures / Q000009:adverse effects / Q000706:statistics & numerical data*; D006801:Humans; D002532:Intracranial Aneurysm / Q000628:therapy*; D020769:Posterior Cerebral Artery; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology
keywords: Coiling; Endovascular treatment; Parent artery occlusion; Posterior cerebral artery aneurysms; Posterior circulation aneurysms