How is posterior communicating artery aneurysm treated?
How is posterior communicating artery aneurysm treated?
Treatment options of PCOM aneurysm include surgical clipping and endovascular techniques; surgical treatment is preferable in large aneurysm especially when it is causing mass effect on the oculomotor nerve, aneurysms with unfavorable fundus, and those associated with fetal PCOM artery origin [3, 4].
Which imaging is the best for PCOM aneurysm?
Digital subtraction angiography (DSA) can be useful compared with noninvasive imaging for identification and evaluation of cerebral aneurysms if surgical or endovascular treatment is being considered. DSA is the most sensitive imaging for follow-up of treated aneurysms. CTA and MRA are useful for detection of UIA.
Where is the posterior communicating artery located?
The PCOM is located in the back of the head at the back end of the circle of Willis. It is located on the left and right sides of the head and is relatively short. The posterior cerebral arteries branch off from the basilar artery.
Where is PCOM aneurysm?
Oculomotor Nerve (Cranial Nerve III) Posterior communicating artery aneurysms (PComA) at the junction of the posterior communicating and internal carotid arteries are neurological emergencies that may present as isolated painful third nerve palsies.
What is PCOM aneurysm?
Posterior communicating artery (PCOM) aneurysms are one of the most common aneurysms encountered by neurosurgeons and neurointerventional radiologists and are the second most common aneurysms overall (25% of all aneurysms) representing 50% of all internal carotid artery (ICA) aneurysms.
Is Pcom anterior or posterior circulation?
Anterior and posterior circulations provide the primary blood circulation of the brain. Both circulations are connected by the posterior communicating arteries (PCOM), which make up the circle of Willis.
Is CTA better than MRA?
Wilke said. Because of this and its short acquisition time, CTA holds an advantage over MRA in coronary imaging. “However, in cardiac CT, there’s going to be around 20 to 30 percent of patients where it’s not that clear cut — whether there’s disease or not and whether the disease is significant or not,” Dr.
How is PCOM aneurysm diagnosed?
Expert interpretation of modern noninvasive neuroimaging such as computed tomographic angiography (CTA) and magnetic resonance angiography (MRA), should detect nearly all aneurysms responsible for an isolated third nerve palsy.
What does Pcom stand for?
Philadelphia College of Osteopathic Medicine
| Former names | Philadelphia College and Infirmary of Osteopathy |
|---|---|
| Academic staff | 183 |
| Students | 2,855 |
| Location | Philadelphia, PA; Suwanee, GA; Moultrie, GA , United States |
| Campus | Urban, 17 acres (Philadelphia) 20 acres (Georgia) |
What is a fetal Pcom?
A fetal (origin of the) posterior cerebral artery is a common variant in the posterior cerebral circulation, estimated to occur in 20-30% of individuals 2. The posterior communicating artery (PCom) is larger than the P1 segment of the posterior cerebral artery (PCA) and supplies the bulk of the blood to the PCA.
Can a PCOM aneurysm originate off the PCOM artery?
Rarely, the neck of the aneurysm may originate solely off of the PCOM artery itself. The direction of the dome also has significant surgical implications. A classification system has been described by Yasargil.[59] When the fundus points anteriolaterally, the origin of the PCOM artery may be hidden by the aneurysm.
What is the best treatment for posterior communicating artery aneurysms?
Posterior communicating artery aneurysms with an elongated fundus, true posterior communicating artery aneurysms, and aneurysms associated with a fetal posterior communicating artery may have better outcome with surgical clipping in terms of completeness of occlusion and preservation of the posterior communicating artery.
What is a fetal PCOM artery?
A fetal PCOM variant is defined as a PCOM artery, which has the same caliber as the P2 segment of the PCA and is associated with an atrophic P1 segment. Because fetal PCOM arteries are the primary supply to the PCA, care must be taken not to compromise flow to this artery during clipping or coiling of PCOM aneurysms.
What is the incidence of PCOM in the US?
The incidence of the fetal PCOM variant is 4-29% of patients and bilateral fetal PCOM variants occur in 1-9% of patients. [ 6, 21, 24, 46, 52] There is also considerable variation in the extent of involvement of the PCOM artery by the neck of the aneurysm.
