• Carmelo Lucio Sturiale, Chiara De Waure, Giuseppe Maria Della Pepa, Giovanna Elisa Calabrò, Alessio Albanese, Francesco D'Argento, Eduardo Fernandez, Alessandro Olivi, Alfredo Puca, Alessandro Pedicelli, and Enrico Marchese.
• Institute of Neurosurgery, Catholic University School of Medicine, Rome, Italy. Electronic address: cropcircle.2000@virgilio.it.
• World Neurosurg. 2016 Jul 1; 91: 154-62.

BackgroundEndovascular treatment of posterior cerebral artery aneurysms is challenging because of the particular features of posterior circulation vessels. We performed a systematic review of the literature, to assess safety and efficacy associated to their endovascular treatment.MethodsThrough a literature search, we identified 20 studies that met our inclusion criteria. We also performed a retrospective analysis of patients treated at our institution during the last 10 years. Demographics, angiographic features, clinical presentation, and outcome were extracted from each study. Data were combined using a random effects model and heterogeneity was assessed by I(2).ResultsWe retrieved 7 patients from our institutional series and 246 from the literature. Overall, 253/259 patients/aneurysms were included in this study. A selective coiling was performed in 27% of cases, a stent-assisted coiling in 2%, and a parent artery occlusion in 62%. Immediate complete/near-complete occlusion was obtained in 96% of cases and maintained in 90% at follow-up. No differences were observed between ruptured and unruptured aneurysms. Ischemic complications were reported in 15% of cases, although the most frequent was a hemianopsia in 7%; a hemiparesis was reported in only 2% of cases. Mortality was overall 1%. Ischemic complications were more frequent among patients who underwent nonselective treatment (P < 0.01).ConclusionsEndovascular treatment of posterior cerebral artery aneurysms is associated with increased degree of occlusion and low recurrence rate. However, a parent artery occlusion implies complications, even although most of them are minor events such as hemianopsia.Copyright © 2016 Elsevier Inc. All rights reserved.

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