Objective To report a single-center experience with endovascular treatment of ruptured proximal posterior inferior cerebellar artery (PICA) aneurysms.
Methods Between January 2007 and December 2016, among 1403 patients with aneurysmal subarachnoid hemorrhage, 15 with ruptured proximal PICA aneurysms underwent endovascular embolization at our institution. Aneurysmal obliteration with a single microcatheter was performed in 9 patients. Additional microcatheter or stent-assisted coil embolization was performed in 4 patients and parent artery occlusion in 2 patients.
Results Immediate angiographic results showed 10 complete occlusions (66.7%, 10/15). Five patients showed incomplete occlusion (remnant neck in 4 patients, remnant aneurysm in 1). Of those, 2 patients experienced recurrence and required conversion to microsurgical clipping. The remaining 2 patients remained in relatively stable condition. Procedure-related complications occurred in 3 patients (20%, with thromboembolic complications in 2 patients and intraprocedural rupture in 1). Clinical outcome was excellent: Glasgow Outcome Score 4 or 5 in 12 of 15 patients (80%). There was no rebleeding during follow-up.
Conclusions Ruptured proximal PICA aneurysms may be effectively treated with endovascular coil embolization. A variety of coil embolization techniques are required to obliterate an aneurysm without parent artery occlusion. Given that recurrence is possible, follow-up is required. Surgical clipping can be performed for recurrence with a relatively low risk of complications, because the aneurysm is unruptured. Coil embolization of a proximal PICA aneurysm in the acute phase can be a good treatment modality with good patient outcomes.
Disclosures Y. Jung: None. H. Lee: None. J. Kim: None. C. Chang: None.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.