Analysis Of Coil Embolization And Surgical Clipping Of Posterior Communicating Artery Aneurysms

Posterior communicating artery aneurysms are one of the most common aneurysms.The anatomic variation of the aneurysms includes the size of PComA and the neck involvement of the aneurysm.During surgical clipping of these aneurysms,anterior clinoidectomy,temporary occlusion,adenosine to cardiac arrest and intraoperative cerebrovascular angiography are good auxiliary methods.Interventional embolization is also an effective treatment,especially in elderly patients.However,the recurrence rate of coiled posterior communicating artery aneurysms is very high and should be followed closely.For wide-necked PComA aneurysms,true PComA aneurysms and aneurysms associated with a fetal PcomA,craniotomy may have a good effect on the complete occlusion of aneurysms and preservation of PComA.However,with the progress of interventional embolization,interventional embolization may be a better choice for the treatment of PComA aneurysms in the near future.1/5 patients with PComA aneurysms present with occulomotor nerve palsy was associated with or without subarachnoid hemorrhage.Therapeutic time window and partial third nerve deficit were associated with the third nerve function recovery.Both craniotomy and interventional embolization provide a reasonable chance for patients to recover.According to the second-level evidence,clipping appears to offer a higher chance of occulomotor nerve palsy recovery;however,coiling will remain as an option particularly in elderly patients or patients with significant comorbidity.