The Safety and Efficiency of Parent Artery Occlusion according to the Location of Occlusion

Background and Purpose: Reconstructive treatment methods for aneurysms are increasing, but their use over traditional endovascular parent artery occlusion (PAO) remains debated. The purpose of this study was to examine the safety and efficacy of planned intra- and extracranial PAO. Materials and Methods: A retrospective chart review was conducted on consecutive patients who underwent endovascular treatment for PAO at our institution between 1999 and 2017. Patients who underwent planned and intentional PAO were included in the study. Information was collected on demographics, clinical symptoms, imaging findings, and follow-up outcomes. Findings were presented according to PAO performed intra- and extra-cranially. Results: Among 1000 endovascular treatment, 32 patients (19 women; 13 men; mean age 53±13.2 years) had planned PAO. PAO was performed intracranially in 11 and extracranially in 21 patients. Permanent neurological deficits were seen in 36.36% and 4.76% of intracranial and extracranial PAO, respectively. Intracranial PAO was independently associated with higher neurological complications than extracranial PAO (odds ratio: 11.43; 95% confidence interval: 0.83-158.07; p-value: 0.02). No patients with PAO with balloon test occlusion (BTO) had any perioperative neurological complications. Conclusion: Efficacy of PAO in our small study was 100%. Intracranial PAO was an independent predictor for associated neurological morbidity compared to extracranial PAO. BTO appeared to help avoid neurological complications.