Efficacy and long-term results of endovascular embolization and surgical clipping for posterior communicating artery unruptured aneurysms complicated with oculomotor nerve palsy. Issue 34 (26th August 2022)

• Record Type: Journal Article
• Authors: Shen, Xun; Wang, Wenlei; Qin, Huaihai; Ren, Chun-Feng; Gao, Bu-Lang
• Is Part Of: Medicine. Volume 101:Issue 34(2022)
• Page Start: e30421
• Publication Date: 2022-08-26
• Subjects: endovascular embolization -- surgical clipping -- posterior communicating artery -- intracranial aneurysms -- oculomotor nerve palsy; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000030421
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract : This study aimed: to investigate the efficacy and long-term outcomes of endovascular embolization and surgical clipping for patients with posterior communicating artery unruptured aneurysms (PcomAs) concomitant with oculomotor nerve palsy (ONP). No significant ( P > .05) difference existed in the age, gender, proportion of complete ONP, and size of eye fissure and pupil before treatment between 2 groups. After compared with before treatment, the eye fissure was widened significantly ( P < .05) and the pupil narrowed significantly ( P < .05), but no significant ( P > .05) differences existed between the 2 groups. Complete ONP recovery was observed in 32 (80%) patients in the embolization group and 31 (77.5%) in the microsurgical group, partial ONP recovery occurred in 6 (15%) in the embolization group and 8 (20%) in the microsurgical group. The recovery rate was 95% in the embolization group and 97.5% in the microsurgical group, with no significant ( P > .05) difference between 2 groups. The recovery rate of the ONP was significantly ( P < .01) greater in the microsurgical group than that in the embolization group at follow-up of 1 month, 3 months, six and 12 months, respectively. At 18 months, the ONP recovery rate was not significantly different between 2 groups (95% vs 97.5%) Surgical clipping may have a faster effect on the recovery of oculomotor nerve palsy than endovascular embolization for patients with posterior communicating artery unruptured aneurysms complicated with oculomotor nerve palsy, but both approaches may result in a similar effect on the nerve recovery in the long run. Eighty patients treated with endovascular embolization or surgical clipping were retrospectively enrolled into the endovascular embolization group or surgical clipping and analyzed.