Wide-Necked Posterior Communicating Artery Aneurysm

Endovascular treatment for wide-necked posterior communicating artery aneurysm with a Fetal-type posterior cerebral artery (PCA) is often challenging. Since the complete occlusion rates achieved with the currently available treatment methods are unsatisfactory, Nariai et al. aimed to study the effectiveness of a double-balloon remodeling technique for these aneurysms. From September 2014 to August 2020, 6 consecutive patients with PcomA aneurysms with Fetal-type posterior cerebral artery and no previous treatment were treated with this technique (3 ruptured cases and 3 unruptured cases). The indication for this technique is that the aneurysm neck should significantly and broadly incorporate both the internal carotid artery and Fetal-type posterior cerebral artery, such that a single-balloon remodeling and a single stent would be inadequate to protect both the arteries. In all patients, the fetal-type PCAs were preserved without a stent and with adequate occlusion status. This double-balloon technique can be effective in the treatment of these aneurysms ¹⁾.