Introduction: Superior cerebellar artery (SCA) aneurysms have distinctive morphologic configurations and vascular origins. Herein, we have analyzed the angioarchitectural characteristics of SCA aneurysms and outcomes achieved through endovascular treatment.
Methods: Data accruing prospectively from January, 2002 to September, 2013 yielded 53 SCA aneurysms in 53 patients. Each lesion was classified as either basilar artery (BA), BA-SCA, or SCA type, according to the nature of incorporated vasculature. Clinical and morphologic outcomes were assessed, with emphasis on technical aspects of treatment.
Results: Angles formed by SCA and posterior cerebral artery were obtuse (124.8 ± 29.1°) on sides ipsilateral to aneurysms, differing significantly from contralateral counterparts (44.8 ± 22.0°) (p<0.001). The most common type of aneurysm was BA-SCA (54.7 %), followed by SCA (28.3 %) and BA (17.0 %), and BA type aneurysms were the largest in size. Steam-shaped S-configured microcatheters (n=19, 67.9 %) facilitated aneurysm selection for approach via contralateral vertebral artery (n=28), whereas pre-shaped 45/90/J microcatheters (n=21, 84.0 %) primarily were used for ipsilateral vertebral artery approach (n=25). Single-microcatheter technique (52.8 %) was most often applied, followed by double-microcatheter (34.0 %), stent-assisted (9.4 %), and microcatheter-protection techniques (3.8 %). Aneurysmal occlusion was satisfactorily achieved in 45 lesions (82.1 %), with no procedure-related morbidity and mortality. In follow-up monitoring of 46 patients for a mean period of 25.8 ± 24.4 months, only a single instance of major recanalization (2.2 %) occurred.
Conclusion: Coil embolization of SCA aneurysms is a safe and effective treatment modality, enabling individualized procedural strategies to accommodate distinctive angio-anatomic configurations.