Ten years of experience in endovascular treatment of ruptured aneurysms of the posterior inferior cerebellar artery

Abstract

<jats:sec><jats:title>Background</jats:title><jats:p> The aim of this study is to present our 10 years of experience in endovascular treatment of ruptured posterior inferior cerebellar artery (PICA) saccular aneurysms and to compare clinical presentation and outcome after endovascular treatment between patients with PICA aneurysms and patients with aneurysms in different locations. </jats:p></jats:sec><jats:sec><jats:title>Methods and findings</jats:title><jats:p> Out of 932 patients with a ruptured intracranial aneurysm treated endovascularly in our institution, 38 aneurysms were located at the posterior inferior cerebellar artery. Clinical presentation, mean aneurysm diameter and outcome of the therapy in this group were compared with the same for ruptured aneurysms in other locations. Patients discharged with favourable outcomes were checked angiographically in the follow-up period. Thirty-four patients with ruptured PICA aneurysms were treated by selective endovascular coiling. Two patients with wide-necked aneurysms had endovascular stents implanted. In two cases, the parent vessel was occluded due to failure to catheterise the target aneurysm. The evaluated variables did not differ significantly between two groups, but significantly more ruptured aneurysms in the PICA group were under 6 mm in diameter. 29.4% of controlled aneurysms needed additional reembolisation in the follow-up period. </jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p> Clinical presentation, extension of subarachnoid haemorrhage and outcome after endovascular treatment did not differ significantly between patients with ruptured aneurysms located on the PICA and patients with aneurysms located elsewhere intracranially. Endovascular treatment is an effective method of therapy in patients with ruptured PICA aneurysms. In our experience, even when sacrificing of the PICA is required, the results of treatment are favourable. </jats:p></jats:sec>

Clinical Importance of the Posterior Inferior Cerebellar Artery: A Review of the Literature

“…A meta-analysis suggested PICA aneurysms treated with EVT had a higher recurrence rate and lower occlusion rate than those treated with surgery 35 . Robert et al also reported 29.4% of the patients who underwent EVT required retreatment due to aneurysm recurrence 72 . The safety and efficacy of EVT still need to be improved.…”

Simple Lateral Suboccipital Approach and Modification for Vertebral Artery Aneurysms: A Study of 52 Cases Over 10 Years

“…60,63,[65][66][67] The endovascular retreatment rate for VA and PICA aneurysms was reported around 20%e30%. 58,68 A recent comparative study between clipping and coiling in 102 patients with VA and PICA aneurysm 69 did not show any significant difference in the patients' clinical outcomes. Our results compare favorably with these endovascular results.…”

Clinical evaluation of endovascular treatment of posterior inferior cerebellar artery (PICA) aneurysms

“…Ayrıca bu bölgede zengin perforanların bulunması gerek cerrahi gerekse endovasküler tedavide güçlükler oluşturur. Özellikle disekan olan anevrizmaların ayırt edilmesi, bunların tedavisinde farklı yaklaşım gerekmesi nedeniyle önemlidir [4,[10][11][12].…”