Dokument: Review of treatment modalities and clinical outcome of giant saccular posterior cerebral artery aneurysms

Titel:Review of treatment modalities and clinical outcome of giant saccular posterior cerebral artery aneurysms
URL für Lesezeichen:https://docserv.uni-duesseldorf.de/servlets/DocumentServlet?id=70218
URN (NBN):urn:nbn:de:hbz:061-20250716-143332-6
Kollektion:Publikationen
Sprache:Englisch
Dokumententyp:Wissenschaftliche Texte » Artikel, Aufsatz
Medientyp:Text
Autoren: Theofanopoulos, Andreas [Autor]
Khajuria, Rajiv Kumar [Autor]
Khan, Dilaware [Autor]
Troude, Lucas [Autor]
Waldau, Ben [Autor]
Faust, Katharina [Autor]
Muhammad, Sajjad [Autor]
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Dateien vom 16.07.2025 / geändert 16.07.2025
Stichwörter:Outcome, Giant PCA aneurysm, Surgical treatment, Endovascular treatment
Beschreibung:Introduction
Giant saccular posterior cerebral artery (PCA) aneurysms are rare lesions carrying significant morbidity due to mass effect and present therapeutic challenges, mainly due to the challenging approach required for aneurysm obliteration.
Research question
To review treatment modalities and outcomes of patients harboring giant (>2.5 cm) PCA saccular aneurysms distal to the basilar bifurcation.
Materials and methods
A systematic literature review through PubMed and Scopus to identify cases of giant saccular PCA aneurysms treated either microsurgically or endovascularly. Patients’ demographics, aneurysm size, preoperative and postoperative neurologic status, clinical outcomes and follow-up information were retrieved.
Results
Data from 33 studies including 55 patients were obtained. Mean patient age was 34.35 years. Mean maximum aneurysm diameter was 38.48 mm. Presentation was aneurysm rupture in 30.9 %, headache in 23.6 %, hemiparesis or tetraparesis in 12.7 %, hemianopsia in 10.9 % and hydrocephalus in 5.5 %. At least 30.9 % had significant brainstem compression. Treatment was endovascular in 23.6 %, microsurgical in 67.3 % and combined in 9.1 %. Debulking to reduce mass effect was required in 32.4 %. Preoperative mRS ranged from 1 to 5. A favorable outcome (mRS 0–2) was reported on 92.7 % of cases. Death rate was 3.6 %. The PCA was sacrificed in 40 % of the patients without severe neurologic morbidity. Follow-up ranged from 1 week to 11 years.
Discussion and conclusion
Giant PCA aneurysms are amenable to both treatment modalities. PCA sacrifice may be required and is often well tolerated, presumably due to the rich collateral supply. Mass effect may necessitate debulking. PCA bypass may be required, but carries significant morbidity.
Rechtliche Vermerke:Originalveröffentlichung:
Theofanopoulos, A., Khajuria, R. K., Khan, D., Troude, L., Waldau, B., Faust, K., & Muhammad, S. (2025). Review of treatment modalities and clinical outcome of giant saccular posterior cerebral artery aneurysms. Brain and Spine, 5, Article 104309. https://doi.org/10.1016/j.bas.2025.104309
Lizenz:Creative Commons Lizenzvertrag
Dieses Werk ist lizenziert unter einer Creative Commons Namensnennung 4.0 International Lizenz
Fachbereich / Einrichtung:Medizinische Fakultät
Dokument erstellt am:16.07.2025
Dateien geändert am:16.07.2025
english
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