Treatment of unruptured posterior communicating artery aneurysm: a comparison of clipping and coil embolization

Background and Purpose: To review the treatment of an unruptured posterior communicating artery aneurysm. Methods: Fifty-five patients who underwent neurosurgical treatment (NST: 38 cases) and endovascular treatment (EVT: 17 cases) at our hospital from July 2009 to November 2023 were included. Surgical time, complications, and recurrence were compared retrospectively. Results: Surgical time was significantly different, with NST taking 209 minutes and EVT taking 135 minutes. Complications occurred in 2 NST cases and 0 EVT cases, showing no significant difference. Recurrence was observed in 0 NST cases and 3 EVT cases (with posterior communicating artery branching from the dome), with a significant difference. Conclusion: NST treatment is comparable in complications but superior in terms of recurrence. Adequate consideration of the branching of the posterior communicating artery is crucial for treatment selection.