Aims: The objective of this article is to report our experience with the two treatment approaches in patients with PICA aneurysms and find predictive factors for treatment-related complications.
Materials and methods: Between January 2011 and December 2015, patients with PICA aneurysm who underwent surgical and endovascular treatment were retrospectively collected and reviewed. Patients' demographic features, treatment-related complications, and long-term angiographic and clinical outcomes (modified Rankin Scale [mRS]) between the two groups were compared. Multivariable logistic analysis was used to find statistically significant predictive factors for treatment-related complications.
Results: A total of 55 PICA aneurysms were identified, 13 were ruptured, and 42 unruptured. Endovascular treatment was performed in 26 patients and surgical clipping in 29 patients. Treatment-related complications occurred in one patient in the embolization group compared with 9 in the microsurgical surgery group (3.8% vs. 31.0%, P = 0.010). Multivariate logistic analysis showed that treatment modality was the only predictor for treatment-related complications. A lower recurrence rate was found in the microsurgical surgery group compared with the embolization group (3.4% vs. 7.7%, P = 0.493). Clinical follow-up showed that endovascular treatment achieved better outcomes (mRS ≤2) compared with surgical treatment (96.2% vs. 89.7%, P = 0.359).
Conclusions: This study of PICA aneurysms demonstrates that results of both treatment modalities are comparable. To obtain the best treatment outcomes, cooperation between interventional neuroradiologist and endovascular neurosurgeons in deciding the optimal treatment is essential.
Keywords: Aneurysm; endovascular; management; outcome; posterior inferior cerebellar artery; surgical.