True aneurysms of the posterior communicating artery: a systematic review and meta-analysis of individual patient data

World Neurosurg. 2011 Jan;75(1):64-72; discussion 49. doi: 10.1016/j.wneu.2010.09.012.

Abstract

Objective: To review and analyze systematically the reported cases of "true" posterior communicating artery (PCoA) aneurysm.

Methods: A retrospective review of the published literature was performed, and a meta-analysis of individual patient data was conducted.

Results: Pooled data showed that "true" PCoA aneurysms represent about 1.3% (95% confidence interval [CI] 0.8%, 1.7%) of all intracranial aneurysms and 6.8% (95% CI 4.3%, 9.2%) of all PCoA aneurysms. Mean patient age was 53.5 years (53.5 years ± 15.4), and age range was 23-79 years. Of the 49 patients reported in the literature, 44 (89.8%) were reported as ruptured, and 4 (10.2%) were reported as unruptured. There were no significant differences in ruptured status between age (P = 0.321), left vs right aneurysm (P = 0.537), and shape of aneurysm (P = 0.408). No significant differences in complication rates were found between rupture status (P = 0.27), and operative modalities (P = 0.878). The mean ages of patients who had no complications and patients who had complications were 53 years (53 years ± 2.59) vs 53.2 years (53.2 years ± 5.02) (P = 0.972).

Conclusions: "True" PCoA aneurysms represent about 1.3% of all intracranial aneurysms and 6.8% of all PCoA aneurysms. They are more prone to rupture compared with their counterpart junctional aneurysms. When surgical management is indicated, a good understanding of the location and configuration of the aneurysm neck before surgical treatment is critical in the successful treatment of these lesions.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Circle of Willis / diagnostic imaging
  • Circle of Willis / pathology*
  • Circle of Willis / physiopathology
  • Humans
  • Incidence
  • Intracranial Aneurysm / complications
  • Intracranial Aneurysm / epidemiology*
  • Intracranial Aneurysm / pathology*
  • Middle Aged
  • Neurosurgical Procedures / methods
  • Neurosurgical Procedures / standards
  • Radiography
  • Retrospective Studies
  • Severity of Illness Index
  • Sex Distribution
  • Subarachnoid Hemorrhage / complications
  • Subarachnoid Hemorrhage / epidemiology*
  • Subarachnoid Hemorrhage / pathology*
  • Vascular Surgical Procedures / methods
  • Vascular Surgical Procedures / standards
  • Young Adult