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Risk factors of recurrence of posterior communicating artery aneurysm treated by flow diverter and alternative treatment strategies
1108 08:10-08:20
Cerebrovascular/304B
Objective This study aims to identify risk factors associated with the recurrence of posterior communicating artery aneurysms after treatment with flow diverters and to explore various stenting strategies that involve deploying the stent into the posterior communicating artery. Methods We conducted a retrospective review of the clinical and radiological data for 69 patients treated with flow diverters for posterior communicating artery aneurysms at a single tertiary center from January 2012 to March 2022. We applied univariate and multivariate analyses to assess the relationship between clinical and radiological variables and the recurrence of aneurysms. Results Out of the 69 treated cases, 23.1% (16 patients) had ruptured aneurysms, and 91.3% (63 patients) were female. A fetal-type posterior communicating artery was present in 30.4% (21 patients) of cases. The overall recurrence rate was 30.4%. Multivariate logistic regression analysis identified age (OR = 1.241; 95% CI 1.035-1.649) and the presence of a fetal-type posterior communicating artery (OR = 0.013; 95% CI 1.530-10.475) as significant predictors of recurrence post-flow diverter treatment. The study also explored various stenting techniques to enhance the occlusion success rate in aneurysms associated with a fetal-type posterior communicating artery. Conclusion The findings suggest that older age and the presence of a fetal-type posterior communicating artery are significant independent risk factors for the recurrence of posterior communicating artery aneurysms after flow diverter treatment. Implementing stents directly into the posterior communicating artery could lead to more effective aneurysm occlusion while maintaining artery patency, offering a viable alternative treatment approach for these aneurysms.