Clinical Study Of 51 Cases With Posterior Communicating Artery Infundibular Dilatation

ObjectiveTo obtain the incidence of posterior communicating artery infundibular dilatation (Pcom-ID) based on Digital Subtraction Angiography (DSA) about the Neurosurgery department of First Affiliated Hospital, Zhejiang University, describe the clinical features of patients with Pcom-ID, analyze the risk factors and discuss the value of Computed Tomography Angiography (CTA) for the diagnosis of Pcom-ID and the way to improve diagnostic accuracy. In addition, we reported the special cases and summarized the outcome of Pcom-ID. Finally reinforce the recognition of Pcom-ID and provide theoretical support for the diagnosis and treatment in clinic.MethodsWe acquired the incidence of Pcom-ID by collecting the clinical datas of patients who were examined with DSA from January 2014 to January 2016 depending on the inclusion and exclusion criteria. And we obtained the risk factors comparing to the normal group. Besides, we evaluated the accuracy of CTA taking DSA as golden standard and effectiveness of innovation. Lastly, we summarized the characteristic and outcome by reviewing the special cases.Results51 cases with Pcom-ID were included in our study from 857 cases who did DSA examination. The incidence was 5.9%.31.37% of patients were male and 68.63% female. The average age of presentation was 54 years which Concentrated between 40 and 70 years. The history of smoking was found in 27.45% of patients, alcohol in 17.65%, hypertension in 43.14%, diabetes in 3.92%.54.90% of patients also had aneurysm which 25.49% were posterior communicating aneurysm. In 51 cases,2 cases had evolved into aneurysms and 1 case was suspected to rupture. We also found that Pcom-ID tended to older women and hypertension was one of risk factors. Moreover, the accuracy of CTA for diagnosis of Pcom-ID was 21.21% and 36.36% with the use of new methods.ConclusionsThe incidence of Pcom-ID was 5.9% on the basis of DSA in our center mostly accompanied by aneurysms. Female, older age and hypertension were the risk factors of Pcom-ID. The value of CTA for diagnosis and follow-up of Pcom-ID was limited. However, we could enhance the accuracy rate by changing the threshold and adjusting the viewing Angle combined with morphological feature of Pcom-ID. Moreover, Pcom-ID could occur direct rupture, rupture resulted from bleb-like structure and rupture caused by aneurysm.