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Effects of surgical clipping and endovascular embolization on the recovery of oculomotor nerve paralysis caused by posterior communicating artery aneurysm

Background and Objectives: Our study aimed to explore the therapeutic effects of surgical clipping and endovascular embolization on the recovery of oculomotor nerve paralysis (ONP) caused by posterior communicating artery aneurysm (PcomAA).
Methods: The clinical data of patients with intracranial PcomAA and ONP were retrospectively analyzed. All patients were treated with surgical clipping or endovascular embolization, then followed up for no less than 12 months. Logistic regression analysis was performed to analyze the potential risk factors influencing ONP recovery.
Results: Among 128 patients of ONP caused by PcomAA, 96 patients were treated with surgical clipping and 32 patients with endovascular embolization, respectively. Time from initial ONP onset to complete or partial recovery was 85.3 ± 36.8 days for patients receiving surgical clipping, and 135.7 ± 41.3 days for patients treated with endovascular embolization. The recovery rate was 94 (97.9%) in the surgical clipping group and 22 (68.8%) in the endovascular embolization group, and significant difference was shown between the two groups (P < 0.001). Logistic regression analyses demonstrated that the complete or partial recovery of ONP in the surgical clipping group was significantly better than that in the endovascular embolization group (OR, 5.582; 95%CI, 2.023-15.405; P <0.001). Moreover, time from initial symptom onset to receiving treatment also affect ONP recovery (OR, 0.893; 95% CI, 0.820-0.972; P = 0.009).
Conclusion: Surgical clipping was superior to endovascular embolization in the recovery of ONP caused by PcomAA, and patients who received early intervention could result in better ONP recovery.