Abstract
Internal carotid-posterior communicating artery aneurysms (IC-PC An) are among the most common aneurysms to recur after endovascular treatment. We retrospectively examined the characteristics and treatment methods of 12 IC-PC Ans in 12 patients (11 women; mean age at retreatment, 64 years) who underwent retreatment following initial endovascular therapy. The mean maximum aneurysm diameter was 10.0 mm, and the mean neck diameter was 5.1 mm. An incorporated posterior communicating artery (Pcom) was present in 7 cases and a fetal Pcom (absent P1 segment) was observed in 2 cases. Initial treatment techniques included simple coiling in 7 cases, balloon-assisted coiling in 1 case, and stent-assisted coiling (SAC) in 4 cases. Initial embolization results were complete occlusion (CO) in 1 case, neck remnant in 8 cases, and body filling in 3 cases. The median interval from initial treatment to retreatment was 30 months. For retreatment, additional coil embolization was performed for patients who initially underwent SAC, while SAC or flow diverter (FD) implantation was performed in all other patients except one who had coiling with simple or balloon-assisted techniques. One patient required a second retreatment. No delayed ruptures occurred. Endovascular retreatment of IC-PC Ans tailored to the initial treatment method was generally effective and safe. However, some aneurysms remained difficult to fully control. Along with developing improved retreatment strategies, it will be important to consider initial treatment options, including the use of FD, in future cases.
