• Peeraphong Thiarawat, Behnam Rezai Jahromi, Danil A Kozyrev, Patcharin Intarakhao, Mario K Teo, Joham Choque-Velasquez, Mika Niemelä, and Juha Hernesniemi.
• Department of Neurosurgery, Helsinki University Hospital, Helsinki, Finland.
• Neurosurgery. 2019 Jun 1; 84 (6): 1306-1312.

BackgroundFetal-type posterior cerebral arteries (F-PCAs) might result in alterations in hemodynamic flow patterns and may predispose an individual to an increased risk of posterior communicating artery aneurysms (PCoAAs).ObjectiveTo determine the association between PCoAAs and the presence of ipsilateral F-PCAs.MethodsWe retrospectively reviewed the radiographic findings from 185 patients harboring 199 PCoAAs that were treated at our institution between 2005 and 2015. Our study population consisted of 4 cohorts: (A) patients with 171 internal carotid arteries (ICAs) harboring unilateral PCoAAs; (B) 171 unaffected ICAs in the same patients from the first group; (C) 28 ICAs of 14 patients with bilateral PCoAAs; and (D) 180 ICAs of 90 patients with aneurysms in other locations. We then determined the presence of ipsilateral F-PCAs and recorded all aneurysm characteristics.ResultsGroup A had the highest prevalence of F-PCAs (42%) compared to 19% in group B, 3% in group C, and 14% in group D (odds ratio A : B = 3.041; A : C = 19.626; and A : D = 4.308; P < .001). PCoAAs were associated with larger diameters of the posterior communicating arteries (median value 1.05 vs 0.86 mm; P = .001). The presence of F-PCAs was associated with larger sizes of the aneurysm necks (median value 3.3 vs 3.0 mm; P = .02).ConclusionPCoAAs were associated with a higher prevalence of ipsilateral F-PCAs. This variant was associated with larger sizes of the aneurysm necks but was not associated with the sizes of the aneurysm domes or with their rupture statuses.Copyright © 2018 by the Congress of Neurological Surgeons.

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