{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T23:30:07Z","timestamp":1788219007001,"version":"build-2803163510"},"reference-count":33,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T00:00:00Z","timestamp":1753228800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Interv Neuroradiol"],"abstract":"<jats:sec>\n                    <jats:title>Background and objectives<\/jats:title>\n                    <jats:p>Fetal posterior cerebral artery (fPCA) is a common anatomical variant where the P1 segment is hypoplastic or absent, and the posterior communicating artery supplies the posterior cerebral artery (PCA) territory. Aneurysms in this setting often form at the internal carotid artery (ICA)\u2013posterior communicating artery junction and are poorly defined. This study introduces a novel classification to address the fPCA variant, treatment challenges, and outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This registry-based study included fPCA aneurysms treated endovascularly at the Medical University of South Carolina (2013\u20132024). Aneurysms are classified into type-1 (shared neck with ICA and fPCA), type-2 (neck arises from ICA, and fPCA originates from the aneurysm), and type-3 (neck originates entirely from fPCA). Aneurysm type, treatment strategy, and outcomes were compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Forty fPCAs, consisting of 20 type-1, 15 type-2, and five type-3 aneurysms, were analyzed. For type-1 aneurysms, recurrence on admission was higher (40%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.03, V\u2009=\u20090.34 [95% CI: 0.22\u20130.56]). In addition, maximum diameter (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.02, \u03b7\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.17) and neck size (\n                      <jats:italic toggle=\"yes\">p\u2009<\/jats:italic>\n                      =\u20090.001, \u03b7\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.32) were larger in type-2 aneurysms. Treatment modalities included coiling alone (55%), stent-assisted coiling (17.5%), and flow diversion (FD) (27.5%). All coil-alone treatments were performed in newly presented ruptured aneurysm cases (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.01,\n                      <jats:italic toggle=\"yes\">V<\/jats:italic>\n                      \u2009=\u20090.57). FD was mainly used in aneurysm recurrence (54.5%), with adequate occlusion in all patients at one-year follow-up. The lowest occlusion rate was seen in type-2 (86.7% vs. 96%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.54, RR\u2009=\u20090.3 [95% CI: 0.03\u20133.03]) in one-year follow-up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A personalized approach is needed to improve outcomes, particularly in wide-neck bifurcation fPCA aneurysms. Endovascular treatment should be individually adapted to each type to achieve optimal outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15910199251359712","type":"journal-article","created":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T07:14:29Z","timestamp":1753254869000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["A novel classification for posterior communicating artery aneurysms in the presence of fetal posterior cerebral artery: A registry-based study"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-2641-8432","authenticated-orcid":false,"given":"Hasna","family":"Loulida","sequence":"first","affiliation":[{"name":"Medical University of South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9823-2939","authenticated-orcid":false,"given":"Mohammad Mahdi","family":"Bagheri Asl","sequence":"additional","affiliation":[{"name":"Medical University of South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2005-5781","authenticated-orcid":false,"given":"Ariana","family":"Chacon","sequence":"additional","affiliation":[{"name":"Medical University of South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad-Mahdi","family":"Sowlat","sequence":"additional","affiliation":[{"name":"Medical University of South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5643-9480","authenticated-orcid":false,"given":"Zachary Stephen","family":"Hubbard","sequence":"additional","affiliation":[{"name":"Medical University of South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Conor M","family":"Cunningham","sequence":"additional","affiliation":[{"name":"Medical University of South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3778-1565","authenticated-orcid":false,"given":"Imad","family":"Samman Tahhan","sequence":"additional","affiliation":[{"name":"Medical University of South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3138-3484","authenticated-orcid":false,"given":"Julio","family":"Isidor","sequence":"additional","affiliation":[{"name":"Medical University of South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9635-7471","authenticated-orcid":false,"given":"Rahim","family":"Abo Kasem","sequence":"additional","affiliation":[{"name":"Medical University of South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin A","family":"Chetta","sequence":"additional","affiliation":[{"name":"Medical University of South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mulugeta","family":"Gebregziabher","sequence":"additional","affiliation":[{"name":"Medical University of South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro M","family":"Spiotta","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Division of Neuroendovascular Surgery, Medical University of South Carolina, Charleston, SC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,7,23]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1159\/000094007"},{"key":"e_1_3_2_3_2","first-page":"105937","article-title":"Circle of Willis variants: fetal PCA","volume":"2013","author":"Shaban A","year":"2013","unstructured":"Shaban A, Albright KC, Boehme AK, et al. 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