Recanalization of posterior communicating artery aneurysm after coil embolization

Abstract

Introduction: The purpose of this study is to investigate clinical and radiological outcomes related to the recanalization of posterior communicating artery (PcomA) aneurysms after coiling. Comparative analysis was conducted to determine the factors related to the recanalization of PcomA aneurysms after coil embolization and rupture of the recanalized aneurysms. Methods: This study included 176 PcomA aneurysms in 169 patients treated by endovascular coiling at a single center from May 2003 to February 2014. They underwent follow-up digital subtraction angiography or magnetic resonance angiography ≥ 1 year. Results: Recanalization developed in 47 cases (26.7%). Among them, 7 recanalized aneurysms presented with rupture. Risk factors for the recanalization were ruptured aneurysm at initial presentation (p = 0.043

odds ratio [OR] 2.158, confidence interval [CI] 1.023–4.550), size larger than 10 mm (p = 0.001

OR 16.682, CI 3.292–84.541), and longer follow-up duration (longer than 48 months

p = 0.002

OR = 3.105, CI 1.187–5.231) in multivariate analysis. Angiographically, all of the ruptured recanalized aneurysms showed sac regrowth (p = 0.009). The deviated direction of the recanalized part was significantly related with rupture of the recanalized aneurysm (p = 0.019

OR 14.250, CI 1.808–112.323). Conclusions: The recanalization risk factors of PcomA aneurysm after coil embolization were ruptured aneurysm at initial admission, aneurysm size larger than 10 mm, and follow-up duration longer than 48 months. Aneurysmal sac regrowth and deviated direction of the recanalized aneurysm were significantly related with rupture of the recanalized aneurysm after PcomA coil embolization.