抄録
A long-term study of 43 patients with aneurysms at the posterior communicating artery (PCoA) that had resulted in subarachnoid hemorrhage (SAH) was carried out. Twenty-nine of them survived for more than six months after common carotid ligation following SAH, and the other 14, who were conservatively treated, survived for more than six months after the last SAH, which had occurred before admission. In 22 of the patients, long-term follow-up was discontinued because of death (due to rebleeding or other causes), but all the remaining 21 patients are still in the follow-up study. The mean period of follow-up was 15 years and one month. The shortest period of follow-up was one year and the longest 22 years. Fatal rebleeding was observed in one (fatal rebleeding-rate 5.3%) of 19 patients who had had total ligation of the common carotid artery. Rebleeding was observed in six (60%) of 10 patients who had had partial ligation, and fetal rebleeding was later observed in five (fatal rebleeding-rate 50%) of these six patients. Rebleeding was observed in six (43%) of the 14 conservatively treated patients, and fatal rebleeding was later observed in five (fatal rebleeding-rate 36%) of these six patients.
Judging from the results of this study, it was certified that total ligation of the common carotid artery for ruptured PCoA aneurysms controls rebleeding more effectively than partial ligation or conservative treatment.
