Study On The Treatment Of Real Posterior Communicating Artery

Part I Endovascular Treatment of True Posterior Communicating Artery Aneurysms Object: We discuss the safety and efficacy of true posterior communicating artery(true PCo A) aneurysms which are treated by endovascular treatment.Methods:From September 2006 to December 2015,the patients were admitted to people’s hospital of rizhao,the affiliated hospital of qingdao university and qilu hospital of shandong university,which were confirmed they had true PCo A aneurysms by DSA. We collected the following data:sex,age,medical history,clinical outcome,surgical complications and follow-up results.Results:From September 2006 to December 2015, 21 patients were admitted to people’s hospital of rizhao,the affiliated hospital of qingdao university and qilu hospital of shandong university,which were confirmed they had true PCo A aneurysms by DSA.11 cases of them were treated by endovascular treatment.7 patients were female.4 patients were male. The mean age was 61 years old.4 cases of them had the history of hypertension.1 case of them had the history of diabetes.1 case of them had the history of coronary disease.1patient had a surgerical history because of appendicitis in 10 years ago. 4cases displayed oculomotor nerve palsy. Hunt-Hess grades: 6 cases weregrade I; 4 cases were grade Ⅱ;1 cases was grade III. Fisher grades: 8 cases were grade Ⅱ; 3 cases were grade Ⅲ. After DSA examination,according to the size of aneurysm,1 case was small aneurysm and 10 cases were middle aneurysm;according to the size of aneurysms′ neck,The aneurysms′ neck of10 cases were narrow and the aneurysm′s neck of 1 case was wide;according to the situation of true posterior communicating artery aneurysm,9 cases lied in the first paragraph,1 case was located in the second paragraph and 1 case was located in the last paragraph. According to raymond grades, 9aneurysms were completely occluded;2 aneurysms were incompletely occluded. 10 cases were occluded by coil and 1 case were occluded by endovascular stent combined with coil.All patients′ GOS scores were 5.Conclusions:1.Endovascular treatment can be used as the good choice of true PCo A treatment,because of lower surgical complications and higher surgical safety.2. Most homopleural posterior cerebral artery of true posterior communicating artery aneurysm were almost fetal type. It is necessary to protect the patency of the posterior communicating artery.3. The rational choice of surgical approach is the key of successful operation and can reduce postoperative complication,when the ipslilateral internal carotid arteries, due to stenosis or atherosclerotic plaque, were hard to for the guidewire or catheter pass through.Part II Microsurgical Treatment of True Posterior Communicating Artery Aneurysms Object: We discuss the safety and efficacy of true posterior communicating artery aneurysms which are treated by microsurgical treatment.Methods:From September 2006 to December 2015, the patients were admitted to people’s hospital of rizhao,the affiliated hospital of qingdao university and qilu hospital of shandong university,which were confirmed they had true PCo A aneurysms by DSA. We collected the following data:sex,age,medical history,clinical outcome,surgical complications and follow-up results.Results : From September 2006 to December 2015, 21 patients were admitted to people’s hospital of rizhao,the affiliated hospital of qingdao university and qilu hospital of shandong university,which were confirmed they had true PCo A aneurysms by DSA.10 cases of them were treated by surgerical treatment.7 patients were female.3 patients were male. The mean age was 59.9 years old.3 cases of them had the history of hypertension.1 case of them had the history of diabetes.2 cases of them had the history of coronary disease.4 cases of them had smoking history. 1 patient had a surgerical history because of tibial fractures in 5 years ago. 3 cases displayed oculomotor nerve palsy. Hunt-Hess grades: 7 cases were grade I; 3 caseswere grade Ⅱ. Fisher grades: 7 cases were grade Ⅱ;3 cases were grade Ⅲ.After DSA examination,according to the size of aneurysm,2 cases was small aneurysm and 8 cases were middle aneurysm;The situation of true posterior communicating artery aneurysm:9 cases were located in the first paragraph;1 cases were located in the second paragraph.All patients′ GOS scores were 5.Conclusions:1. Microsurgical treatment is one safety and effective treatment for true posterior communicating artery aneurysm.2. According to the part of true posterior communicating artery aneurysm,appropriate surgical approach can be chosen,which can improve the success rate of surgery and reduce complications.