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M.h. Han - One of the best experts on this subject based on the ideXlab platform.
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Posterior Communicating Artery Compromise in Coil Embolization of Posterior Communicating Artery Aneurysms
Clinical Neuroradiology-klinische Neuroradiologie, 2014Co-Authors: Young Dae Cho, Seunguk Jung, Cheol-ho Kim, Jun Hyong Ahn, Hyun Seung Kang, Jeong Eun Kim, M.h. HanAbstract:Purpose Whether the Posterior Communicating Artery (PcomA) can be safely compromised during endovascular treatment of a PcomA aneurysm is a matter of debate. Here we present clinical and radiologic outcomes, given this scenario.
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Stent-assisted coil embolization of Posterior Communicating Artery aneurysms.
American Journal of Neuroradiology, 2013Co-Authors: Young Dae Cho, Hyun Seung Kang, Jeong Eun Kim, Won Jae Lee, Ki-chan Kim, M.h. HanAbstract:BACKGROUND AND PURPOSE: Use of protective stents may not be effective in coil embolization of wide-neck aneurysms involving the Posterior Communicating Artery. Successful implementation depends on the caliber of the vessel, its angle of origin, and the manner in which its orifice is incorporated into the aneurysm. Presented here are the results (clinical and radiographic) of coil embolization in aneurysms of the ICA-Posterior Communicating Artery junction, variably aided by stents. The primary focus is angiographic configurations that impact stent placement. MATERIALS AND METHODS: From a prospective data repository, we retrieved records of 32 consecutive patients with 33 Posterior Communicating Artery aneurysms, all of which were treated by stent-assisted coil embolization between June 2008 and August 2012. Outcomes were analyzed in terms of aneurysm configuration and clinical status. RESULTS: Stents were positioned entirely in the ICA ( n = 26), from the ICA to the Posterior Communicating Artery ( n = 2), in the Posterior Communicating Artery only ( n = 3), and retrograde from the Posterior Communicating Artery to the ICA terminus ( n = 2). Procedure-related complications occurred in 3 patients (9.1%), but only 1 (3.0%) had mild neurologic sequelae (Glasgow Outcome Score 4). Using coil embolization, we achieved successful occlusion in 24 aneurysms (72.7%), and in 9 others, subtotal occlusion was conferred. During a mean follow-up of 15.7 ± 10.7 months, imaging of 27 aneurysms documented stable occlusion in 19 (70.4%), whereas angiography of 15 aneurysms (39.5%) disclosed 2 instances of in-stent stenosis (13.3%) and a solitary occurrence of stent migration (6.7%). CONCLUSIONS: In Posterior Communicating Artery aneurysms, stent protection during coil embolization is feasible by adjusting the procedural strategy to accommodate differing configurations of the aneurysm and its vascular source.
Hayatsura Hanada - One of the best experts on this subject based on the ideXlab platform.
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Stent-Assisted Coil Embolization for a Ruptured Posterior Communicating Artery Pseudoaneurysm After Endoscopic Transsphenoidal Surgery for Pituitary Adenoma.
World Neurosurgery, 2018Co-Authors: Yusuke Morinaga, Kouhei Nii, Kimiya Sakamoto, Ritsurou Inoue, Takafumi Mitsutake, Hayatsura HanadaAbstract:Background Intracranial pseudoaneurysm is a rare complication of endoscopic endonasal surgery. Herein, we describe 2-staged stent-assisted coil embolization for Posterior Communicating Artery pseudoaneurysm after endoscopic endonasal surgery for pituitary adenoma. Case Description A 68-year-old man had a history of severe adult growth hormone secretion deficiency, requiring growth hormone replacement therapy; secondary adrenocortical hypofunction; hyperthyroidism; hypertension; constipation; glaucoma; and hyperuricemia. Five years ago, after initial endoscopic transsphenoidal surgery for pituitary adenoma, he was hospitalized for reoperation. Posterior Communicating Artery injury was observed during second endoscopic transsphenoidal surgery, and pressure hemostasis was performed using a hemostatic preparation. Immediately post surgery, a localized subarachnoid hemorrhage was observed. Sudden-onset impaired consciousness and respiratory disturbances ensued on postoperative day 7, and computed tomography of the head was performed. Recurrent subarachnoid hemorrhage was confirmed, and acute hydrocephalus secondary to third ventricular blockage was identified. Cerebral angiography was performed after urgent bilateral cerebral ventricular drainage under general anesthesia. A pseudoaneurysm was identified in the left Posterior Communicating Artery, and coil embolization was performed. Six weeks post surgery, a low-profile visualized intraluminal stent called an LVIS Jr. stent was placed in the Posterior Communicating Artery. Recurrence of the aneurysm was not detected 6 months post surgery. He underwent lumboperitoneal shunting for secondary normal pressure hydrocephalus after dual antiplatelet therapy discontinuation and is being followed up as an outpatient with a modified Rankin scale score of 2 ten months post surgery. Conclusions Two-staged stent-assisted coil embolization using a low-profile visualized intraluminal stent was effective for a Posterior Communicating Artery pseudoaneurysm occurring after Posterior Communicating Artery injury following endoscopic transsphenoidal surgery for follicle-stimulating hormone-producing pituitary adenoma.
Qinghai Huang - One of the best experts on this subject based on the ideXlab platform.
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Feasibility and midterm outcomes of endovascular embolization for true Posterior Communicating Artery aneurysms.
Neuroradiology, 2019Co-Authors: Wang Chuanchuan, Rui Zhao, Xiaozan Chang, Yibin Fang, Bo Hong, Qinghai Huang, Jianmin LiuAbstract:Purpose Endovascular treatment (EVT) of true Posterior Communicating Artery (PcomA) aneurysms has been rarely reported. This study reports the outcomes on a single-center cohort with true PcomA aneurysms who underwent EVT.
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morphological and hemodynamic discriminators for rupture status in Posterior Communicating Artery aneurysms
PLOS ONE, 2016Co-Authors: Nan Lv, Yibin Fang, Qinghai Huang, Chi Wang, Christof Karmonik, Jinyu Xu, Ying YuAbstract:Background and Purpose The conflicting findings of previous morphological and hemodynamic studies on intracranial aneurysm rupture may be caused by the relatively small sample sizes and the variation in location of the patient-specific aneurysm models. We aimed to determine the discriminators for aneurysm rupture status by focusing on only Posterior Communicating Artery (PCoA) aneurysms.
Young Dae Cho - One of the best experts on this subject based on the ideXlab platform.
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Posterior Communicating Artery Compromise in Coil Embolization of Posterior Communicating Artery Aneurysms
Clinical Neuroradiology-klinische Neuroradiologie, 2014Co-Authors: Young Dae Cho, Seunguk Jung, Cheol-ho Kim, Jun Hyong Ahn, Hyun Seung Kang, Jeong Eun Kim, M.h. HanAbstract:Purpose Whether the Posterior Communicating Artery (PcomA) can be safely compromised during endovascular treatment of a PcomA aneurysm is a matter of debate. Here we present clinical and radiologic outcomes, given this scenario.
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Stent-assisted coil embolization of Posterior Communicating Artery aneurysms.
American Journal of Neuroradiology, 2013Co-Authors: Young Dae Cho, Hyun Seung Kang, Jeong Eun Kim, Won Jae Lee, Ki-chan Kim, M.h. HanAbstract:BACKGROUND AND PURPOSE: Use of protective stents may not be effective in coil embolization of wide-neck aneurysms involving the Posterior Communicating Artery. Successful implementation depends on the caliber of the vessel, its angle of origin, and the manner in which its orifice is incorporated into the aneurysm. Presented here are the results (clinical and radiographic) of coil embolization in aneurysms of the ICA-Posterior Communicating Artery junction, variably aided by stents. The primary focus is angiographic configurations that impact stent placement. MATERIALS AND METHODS: From a prospective data repository, we retrieved records of 32 consecutive patients with 33 Posterior Communicating Artery aneurysms, all of which were treated by stent-assisted coil embolization between June 2008 and August 2012. Outcomes were analyzed in terms of aneurysm configuration and clinical status. RESULTS: Stents were positioned entirely in the ICA ( n = 26), from the ICA to the Posterior Communicating Artery ( n = 2), in the Posterior Communicating Artery only ( n = 3), and retrograde from the Posterior Communicating Artery to the ICA terminus ( n = 2). Procedure-related complications occurred in 3 patients (9.1%), but only 1 (3.0%) had mild neurologic sequelae (Glasgow Outcome Score 4). Using coil embolization, we achieved successful occlusion in 24 aneurysms (72.7%), and in 9 others, subtotal occlusion was conferred. During a mean follow-up of 15.7 ± 10.7 months, imaging of 27 aneurysms documented stable occlusion in 19 (70.4%), whereas angiography of 15 aneurysms (39.5%) disclosed 2 instances of in-stent stenosis (13.3%) and a solitary occurrence of stent migration (6.7%). CONCLUSIONS: In Posterior Communicating Artery aneurysms, stent protection during coil embolization is feasible by adjusting the procedural strategy to accommodate differing configurations of the aneurysm and its vascular source.
Diederik Bulters - One of the best experts on this subject based on the ideXlab platform.
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the resolution of oculomotor nerve palsy caused by unruptured Posterior Communicating Artery aneurysms a cohort study and narrative review
World Neurosurgery, 2017Co-Authors: Samuel Hall, Ahmedramadan Sadek, Alexander Dando, Adam Grose, Borislav D Dimitrov, John Millar, Jason Macdonald, Adam Ditchfield, Owen Sparrow, Diederik BultersAbstract:Objective Recovery of oculomotor nerve palsy after microsurgical and endovascular treatment has been studied in numerous small series of predominantly ruptured aneurysms. Little consideration has been given to the distinction between ruptured and unruptured aneurysms. This study examines the influence of treatment modality on oculomotor palsy recovery as a result of unruptured Posterior Communicating Artery aneurysms. Methods Patients who presented between 2003 and 2015 with an oculomotor palsy secondary to an unruptured Posterior Communicating Artery aneurysm were identified from the hospital database. A keyword search for “Posterior Communicating Artery aneurysm” and “oculomotor nerve palsy OR third nerve palsy” using the PubMed database was performed for the narrative review. Results The cohort study and narrative review identified 15 and 179 eligible patients, respectively. Surgically treated patients in the cohort study did not have a significantly better rate of complete palsy resolution than those who had been coiled ( P = 0.08). In the review, clipping of the aneurysm resulted in a higher rate of complete palsy resolution (70.0%; 95% confidence interval [CI], 60.7%–79.3%) than did coiling (46.5%; 95% CI, 36.0%–57.0%). Patients who presented with an aneurysm 7 mm (68.6%; 95% CI, 57.7%–79.5% vs. 44.3%; 95% CI, 32.7%–55.9%). Patients presenting with a complete palsy (49.4%; 95% CI, 38.6%–60.2%) had a lower rate of recovery than did those with a partial palsy (71.4%; 95% CI, 60.2%–82.6%). Conclusions In this narrative review, surgical clipping of unruptured Posterior Communicating Artery aneurysms was associated with a higher rate of associated oculomotor palsy recovery than was endovascular treatment.