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CC BY-NC-ND 4.0 · Asian J Neurosurg 2024; 19(02): 168-173
DOI: 10.1055/s-0043-1778085
Research Article

It Is Necessary to Pay Attention to Where the Pcom Originate from the Aneurysm to Treat with FD

Autor*innen

  • Takashi Fujii 

    1   Department of Neuroendovascular Therapy, Juntendo University, Graduate School of Medicine, Tokyo, Japan
    2   Department of Neurosurgery, National Defense Medical College, Saitama, Japan

  • Kohsuke Teranishi

    3   Department of Neurosurgery, Juntendo University, Graduate School of Medicine, Tokyo, Japan

  • Yumiko Mitome-Mishima

    2   Department of Neurosurgery, National Defense Medical College, Saitama, Japan
    3   Department of Neurosurgery, Juntendo University, Graduate School of Medicine, Tokyo, Japan

  • Takayuki Kitamura

    3   Department of Neurosurgery, Juntendo University, Graduate School of Medicine, Tokyo, Japan

  • Kojiro Wada

    2   Department of Neurosurgery, National Defense Medical College, Saitama, Japan

  • Akihide Kondo 

    3   Department of Neurosurgery, Juntendo University, Graduate School of Medicine, Tokyo, Japan

  • Hidenori Oishi

    1   Department of Neuroendovascular Therapy, Juntendo University, Graduate School of Medicine, Tokyo, Japan
    3   Department of Neurosurgery, Juntendo University, Graduate School of Medicine, Tokyo, Japan

Funding None.
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Abstract

Objective With the expansion of indications of flow diverter (FD) for cerebral aneurysms, FD placement for posterior communicating artery (Pcom) aneurysms has been approved. However, it is controversial whether Pcom aneurysms should be treated with FD or not. In this study, we report the outcome of FD treatment for Pcom aneurysms in Japan.

Materials and Methods We retrospectively analyzed 36 patients with 38 aneurysms treated with FD placement for Pcom aneurysms between 2015 and 2021 in our hospital. We divided our cases into complete occlusion (CO) and non-CO groups. And we extracted contributing factors to CO using multivariate analysis. We also compared the complications rate among the three types of FDs.

Results CO was obtained in 29 cases (79.3%), and complications were observed in 3 cases (7.9%). Multivariate analysis revealed that the type of Pcom branch from the aneurysmal dome was a significant factor contributing to CO (odds ratio: 0.0052, 95% confidence interval 0.000048–0.584, p = 0.029). In terms of complications, complication rate was significantly higher in the Flow-Redirection Endoluminal Device (FRED) group (p = 0.0491).

Conclusion The outcome for Pcom aneurysms treated by FD was acceptable. When treating, we must pay attention to where Pcom originates. Achieving CO with FD is difficult for aneurysms where the Pcom branches from the dome. Furthermore, when treating Pcom aneurysms with FRED, it is necessary to be careful about thromboembolic complications.

Keywords

aneurysm - flow diverter - Pcom - endovascular - complete occlusion

Ethical Approval

The study was approved by the Institutional Review Board of Juntendo University, Graduate of School of Medicine (E22–0005-H01). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or the national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standers.


Patient Consent

For this type of study, patient consent is not required.


Authors' Contributions

T.F. was involved in conceptualization, methodology, formal analysis and investigation, and writing-original draft preparation. K.T., Y.M.M, and T.K. were involved in methodology. K.W., and A.K. supervised the study. H.O. was involved in review and editing, resources, and supervision.


Supplementary Material



Publikationsverlauf

Artikel online veröffentlicht:
27. Mai 2024

© 2024. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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