Infundibular dilations of the posterior communicating arteries

Pathogenesis, anatomical variants, aneurysm formation, and subarachnoid hemorrhage

Ching Jen Chen, Shayan Moosa, Dale Ding, Daniel M. Raper, Rebecca M. Burke, Cheng Chia Lee, Srinivas Chivukula, Tony R. Wang, Robert M. Starke, R. Webster Crowley, Kenneth Liu

Research output: Contribution to journalReview article

2 Citations (Scopus)

Abstract

Background Cerebrovascular infundibular dilations (IDs) are triangular-shaped widenings less than 3 mm in diameter, which are most commonly found at the posterior communicating artery (PCoA). The aims of this systematic review are to elucidate the natural histories of IDs, determine their risk of progression to significant pathology, and discuss potential management options. Methods A comprehensive literature search of PubMed was used to find all case reports and series relating to cerebral IDs. IDs were classified into three types: Type I IDs do not exhibit morphological change over a long follow-up period, type II IDs evolve into saccular aneurysms, while type III IDs are those that result in subarachnoid hemorrhage without prior aneurysmal progression. Data were extracted from studies that demonstrated type II or III IDs. Results We reviewed 16 cases of type II and seven cases of type III IDs. For type II IDs, 81.3% of patients were female with a median age at diagnosis of 38. All type II IDs were located at the PCoA without a clear predilection for sidedness. Median time to aneurysm progression was 7.5 years. For type III IDs there was no clear gender preponderance and the median age at diagnosis was 51. The PCoA was involved in 85.7% of cases, with 57.1% of IDs occurring on the left. Most patients were treated with clipping. Risk factors for aneurysm formation appear to be female gender, young age, left-sided localization, coexisting aneurysms, and hypertension. Conclusions IDs can rarely progress to aneurysms or rupture. Young patients with type II or III IDs with coexisting aneurysms or hypertension may benefit from long- Term imaging surveillance.

Original languageEnglish (US)
Pages (from-to)791-795
Number of pages5
JournalJournal of NeuroInterventional Surgery
Volume8
Issue number8
DOIs
StatePublished - Aug 1 2016

Fingerprint

Subarachnoid Hemorrhage
Aneurysm
Dilatation
Arteries
Hypertension
Natural History
PubMed
Rupture

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

Cite this

Chen, Ching Jen ; Moosa, Shayan ; Ding, Dale ; Raper, Daniel M. ; Burke, Rebecca M. ; Lee, Cheng Chia ; Chivukula, Srinivas ; Wang, Tony R. ; Starke, Robert M. ; Crowley, R. Webster ; Liu, Kenneth. / Infundibular dilations of the posterior communicating arteries : Pathogenesis, anatomical variants, aneurysm formation, and subarachnoid hemorrhage. In: Journal of NeuroInterventional Surgery. 2016 ; Vol. 8, No. 8. pp. 791-795.
@article{5c0c5c2ad1d14eb8bb07a8581eecdb59,
title = "Infundibular dilations of the posterior communicating arteries: Pathogenesis, anatomical variants, aneurysm formation, and subarachnoid hemorrhage",
abstract = "Background Cerebrovascular infundibular dilations (IDs) are triangular-shaped widenings less than 3 mm in diameter, which are most commonly found at the posterior communicating artery (PCoA). The aims of this systematic review are to elucidate the natural histories of IDs, determine their risk of progression to significant pathology, and discuss potential management options. Methods A comprehensive literature search of PubMed was used to find all case reports and series relating to cerebral IDs. IDs were classified into three types: Type I IDs do not exhibit morphological change over a long follow-up period, type II IDs evolve into saccular aneurysms, while type III IDs are those that result in subarachnoid hemorrhage without prior aneurysmal progression. Data were extracted from studies that demonstrated type II or III IDs. Results We reviewed 16 cases of type II and seven cases of type III IDs. For type II IDs, 81.3{\%} of patients were female with a median age at diagnosis of 38. All type II IDs were located at the PCoA without a clear predilection for sidedness. Median time to aneurysm progression was 7.5 years. For type III IDs there was no clear gender preponderance and the median age at diagnosis was 51. The PCoA was involved in 85.7{\%} of cases, with 57.1{\%} of IDs occurring on the left. Most patients were treated with clipping. Risk factors for aneurysm formation appear to be female gender, young age, left-sided localization, coexisting aneurysms, and hypertension. Conclusions IDs can rarely progress to aneurysms or rupture. Young patients with type II or III IDs with coexisting aneurysms or hypertension may benefit from long- Term imaging surveillance.",
author = "Chen, {Ching Jen} and Shayan Moosa and Dale Ding and Raper, {Daniel M.} and Burke, {Rebecca M.} and Lee, {Cheng Chia} and Srinivas Chivukula and Wang, {Tony R.} and Starke, {Robert M.} and Crowley, {R. Webster} and Kenneth Liu",
year = "2016",
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day = "1",
doi = "10.1136/neurintsurg-2015-011827",
language = "English (US)",
volume = "8",
pages = "791--795",
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Chen, CJ, Moosa, S, Ding, D, Raper, DM, Burke, RM, Lee, CC, Chivukula, S, Wang, TR, Starke, RM, Crowley, RW & Liu, K 2016, 'Infundibular dilations of the posterior communicating arteries: Pathogenesis, anatomical variants, aneurysm formation, and subarachnoid hemorrhage', Journal of NeuroInterventional Surgery, vol. 8, no. 8, pp. 791-795. https://doi.org/10.1136/neurintsurg-2015-011827

Infundibular dilations of the posterior communicating arteries : Pathogenesis, anatomical variants, aneurysm formation, and subarachnoid hemorrhage. / Chen, Ching Jen; Moosa, Shayan; Ding, Dale; Raper, Daniel M.; Burke, Rebecca M.; Lee, Cheng Chia; Chivukula, Srinivas; Wang, Tony R.; Starke, Robert M.; Crowley, R. Webster; Liu, Kenneth.

In: Journal of NeuroInterventional Surgery, Vol. 8, No. 8, 01.08.2016, p. 791-795.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Infundibular dilations of the posterior communicating arteries

T2 - Pathogenesis, anatomical variants, aneurysm formation, and subarachnoid hemorrhage

AU - Chen, Ching Jen

AU - Moosa, Shayan

AU - Ding, Dale

AU - Raper, Daniel M.

AU - Burke, Rebecca M.

AU - Lee, Cheng Chia

AU - Chivukula, Srinivas

AU - Wang, Tony R.

AU - Starke, Robert M.

AU - Crowley, R. Webster

AU - Liu, Kenneth

PY - 2016/8/1

Y1 - 2016/8/1

N2 - Background Cerebrovascular infundibular dilations (IDs) are triangular-shaped widenings less than 3 mm in diameter, which are most commonly found at the posterior communicating artery (PCoA). The aims of this systematic review are to elucidate the natural histories of IDs, determine their risk of progression to significant pathology, and discuss potential management options. Methods A comprehensive literature search of PubMed was used to find all case reports and series relating to cerebral IDs. IDs were classified into three types: Type I IDs do not exhibit morphological change over a long follow-up period, type II IDs evolve into saccular aneurysms, while type III IDs are those that result in subarachnoid hemorrhage without prior aneurysmal progression. Data were extracted from studies that demonstrated type II or III IDs. Results We reviewed 16 cases of type II and seven cases of type III IDs. For type II IDs, 81.3% of patients were female with a median age at diagnosis of 38. All type II IDs were located at the PCoA without a clear predilection for sidedness. Median time to aneurysm progression was 7.5 years. For type III IDs there was no clear gender preponderance and the median age at diagnosis was 51. The PCoA was involved in 85.7% of cases, with 57.1% of IDs occurring on the left. Most patients were treated with clipping. Risk factors for aneurysm formation appear to be female gender, young age, left-sided localization, coexisting aneurysms, and hypertension. Conclusions IDs can rarely progress to aneurysms or rupture. Young patients with type II or III IDs with coexisting aneurysms or hypertension may benefit from long- Term imaging surveillance.

AB - Background Cerebrovascular infundibular dilations (IDs) are triangular-shaped widenings less than 3 mm in diameter, which are most commonly found at the posterior communicating artery (PCoA). The aims of this systematic review are to elucidate the natural histories of IDs, determine their risk of progression to significant pathology, and discuss potential management options. Methods A comprehensive literature search of PubMed was used to find all case reports and series relating to cerebral IDs. IDs were classified into three types: Type I IDs do not exhibit morphological change over a long follow-up period, type II IDs evolve into saccular aneurysms, while type III IDs are those that result in subarachnoid hemorrhage without prior aneurysmal progression. Data were extracted from studies that demonstrated type II or III IDs. Results We reviewed 16 cases of type II and seven cases of type III IDs. For type II IDs, 81.3% of patients were female with a median age at diagnosis of 38. All type II IDs were located at the PCoA without a clear predilection for sidedness. Median time to aneurysm progression was 7.5 years. For type III IDs there was no clear gender preponderance and the median age at diagnosis was 51. The PCoA was involved in 85.7% of cases, with 57.1% of IDs occurring on the left. Most patients were treated with clipping. Risk factors for aneurysm formation appear to be female gender, young age, left-sided localization, coexisting aneurysms, and hypertension. Conclusions IDs can rarely progress to aneurysms or rupture. Young patients with type II or III IDs with coexisting aneurysms or hypertension may benefit from long- Term imaging surveillance.

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U2 - 10.1136/neurintsurg-2015-011827

DO - 10.1136/neurintsurg-2015-011827

M3 - Review article

VL - 8

SP - 791

EP - 795

JO - Journal of NeuroInterventional Surgery

JF - Journal of NeuroInterventional Surgery

SN - 1759-8478

IS - 8

ER -