E-026 Endovascular treatment of pericallosal artery aneurysms: single center experience with early follow up

Traditionally, microsurgical clipping has been the mainstay of treatment for pericallosal artery aneurysms (PAAs). However, this has changed in recent years with advancements in endovascular surgical techniques. We conducted a retrospective cohort study of pericallosal artery aneurysms that underwent endovascular treatment with coiling and flow diversion at our institution. 33 patients with 34 aneurysms were included (25 aneurysms ruptured, 9 unruptured or recurrent). Of the ruptured group, 22 were coiled (88%) and rest treated with flow diversion. Initial angiographic follow up rate was 72% at median of 159 days. Overall recurrence rate was 40% (10/25) at median of 376 days, all among coiled aneurysms. 6 recurrent aneurysms were retreated with further coiling (2) and flow diversion (4). Of the unruptured/recurrent group, 5 were coiled (55%) and remainder treated with flow diversion. Initial angiographic follow up rate was 100% at median of 267 days. Recurrence rate was 22% (2/9), both in coiled aneurysms. Overall, 27 aneurysms were treated with coiling, 9 with flow diversion and 3 with ‘partial’ flow diversion. All aneurysms treated with pipeline flow diversion achieved 100% occlusion. No re-rupture or new rupture was noted in our series. Good clinical outcome (modified Rankin scale, mRS 0–2) was seen in 79% of patients. Our study demonstrates that endovascular coiling for PAAs is associated with a definite rate of recurrence, which has to be monitored with timely angiography. We also demonstrate the excellent effectiveness of flow diversion for PAAs with either presentation. Disclosures M. Sattur: None. Y. Li: None. E. Almallouhi: None. J. Lena: 2; C; Penumbra Inc., Alameda, California. A. Spiotta: 2; C; Penumbra Inc., Alameda, California.