Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=41340738
&cmd=llinks): Failed to open stream: HTTP request failed! HTTP/1.1 429 Too Many Requests
in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 215
Clinical Features and Post-Coiling Outcomes of Symptomatic Internal Carotid
Artery-Posterior Communicating Artery Aneurysms: A Case Series and Literature
Review
#MMPMID41340738
Wajima D
; Kamide T
; Nakada M
Asian J Neurosurg
2025[Dec]; 20
(4
): 780-784
PMID41340738
show ga
OBJECTIVE: This article aims to understand the clinical course of symptomatic
internal carotid artery (ICA)-posterior communicating artery (PCom) aneurysms and
the outcomes of post-coiling for unruptured symptomatic aneurysms by analyzing
the anatomical imaging data and patient backgrounds of patients treated in our
institute in the last 5 years. MATERIALS AND METHODS: This study enrolled 82
patients with ICA-PCom aneurysms. Anatomical factors, including age, sex, side,
aneurysm dome and neck size, aneurysm depth/neck width ratio (ASPECT ratio),
family history of cerebral aneurysm, history of hypertension, smoking habit,
angle between aneurysm dome protrusion and ICA C2 portion, angle between ICA C2
and C3 portions, and PCom diameter, were analyzed. In the outcome analysis of
coil embolization for symptomatic unruptured ICA-PCom aneurysms, we evaluated
age, sex, side, aneurysm dome and neck side, ASPECT ratio, volume embolization
ratio, and time from onset. STATISTICAL ANALYSIS: Mann-Whitney U and Fisher's
exact tests were utilized for quantitative and categorical variables,
respectively. RESULTS: In both ruptured and unruptured ICA-PCom aneurysms, the
angle between the aneurysm dome protrusion and ICA C2 portion and the angle
between the ICA C2 and C3 portions were smaller in the oculomotor palsy group
than in the nonoculomotor palsy group. Other factors such as age, sex, side,
aneurysm dome, neck, ASPECT ratio, family history, hypertension, smoking, and
PCom diameter did not significantly influence oculomotor palsy. Early coil
embolization led to better recovery of neural function, with immediate
intervention offering the highest chance of full recovery. CONCLUSION: Overall,
this study showed that sharp ICA siphon and aneurysm dome protrusion are
significant factors in symptomatic ICA-PCom aneurysms. We propose that immediate
surgery be recommended for patients with ICA-PCom aneurysm-induced oculomotor
nerve palsy to prevent functional disability and potential aneurysm rupture.