Abstract：
Despite advancements in treatment modalities such as flow diverters, the optimal management of posterior communicating artery (PComA) aneurysms remains uncertain. While PComA aneurysms treated with the Pipeline Embolization Device (PED) has been reported, the characteristics and progression of incomplete occluded aneurysms remain unclear. Therefore, our study aims to investigate the occlusion status and recurrence rates of PComA aneurysms treated with PED. A retrospective review of consecutive PComA aneurysm patients treated with PED was conducted between January 2015 and December 2020. Only patients with radiological follow-up were included. PComA aneurysms were categorized into incomplete occlusion and complete occlusion group. The primary outcomes included the characteristics of incomplete occlusion at the follow-up angiography. Among 121 PComA aneurysms treated with PED at our institution, 80 aneurysms were eligible in our study. During the follow-up period, 19 (23.8%) aneurysms demonstrated incomplete occlusion. Notably, there were no instances of recurrence among the 80 followed-up cases. Baseline characteristics of patients and aneurysms were comparable between the groups with complete and incomplete occlusion. However, the incomplete occlusion group showed a lower rate of assisted coils embolization (21.2% vs. 55.7%, P = 0.017) and shorter median operative time (91.0 vs. 145.5 min, P = 0.039). Differences in functional outcomes, complications, and PComA occlusion status between the groups were not significant. Multivariate analysis revealed the use of coils was associated with lower odds of incomplete PComA aneurysm occlusion (OR 0.01, 95% CI 0.001-0.12; P = 0.001), while aneurysm size was associated with higher odds of incomplete occlusion (OR 1.25, 95% CI 1.10-1.46; P = 0.002). The treatment of PED for PComA aneurysm demonstrated favorable outcomes, with an acceptable rate of incomplete occlusion and no instances of recurrence observed. However, further research is needed to explore the optimal procedural strategy for large-sized PComA aneurysms.
摘要：
尽管在治疗方式如分流器方面取得了进步，后交通动脉(PComA)动脉瘤的最佳治疗仍不确定.虽然已经报道了用管道栓塞装置（PED）治疗的PComA动脉瘤，不完全闭塞动脉瘤的特征和进展仍不清楚.因此,本研究旨在探讨PED治疗PComA动脉瘤的闭塞状态和复发率.对2015年1月至2020年12月期间接受PED治疗的连续PComA动脉瘤患者进行了回顾性研究。仅包括接受放射学随访的患者。PComA动脉瘤分为不完全闭塞组和完全闭塞组。主要结果包括随访血管造影时不完全闭塞的特征。在我们机构接受PED治疗的121例PComA动脉瘤中，80个动脉瘤符合我们的研究条件。在后续期间,19例（23.8%）动脉瘤显示不完全闭塞。值得注意的是,在80例随访病例中,没有复发.患者和动脉瘤的基线特征在完全和不完全闭塞组之间具有可比性。然而,不完全闭塞组的辅助弹簧圈栓塞率较低(21.2%vs.55.7%,P=0.017）和较短的中位手术时间（91.0vs.145.5分钟,P=0.039)。功能结果的差异，并发症,且PComA闭塞状态组间差异无统计学意义。多变量分析显示使用线圈与PComA动脉瘤不完全闭塞的几率较低相关(OR0.01,95%CI0.001-0.12;P=0.001),而动脉瘤大小与较高的不完全闭塞几率相关(OR1.25,95%CI1.10-1.46;P=0.002).PED治疗PComA动脉瘤的结果良好,不完全闭塞率可接受，未观察到复发。然而,需要进一步的研究来探索大型PComA动脉瘤的最佳手术策略.
