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World Neurosurg. 2018 Jun;114:e581-e587. doi: 10.1016/j.wneu.2018.03.036. Epub 2018 Mar 14.

Endovascular Treatment of Posterior Inferior Cerebellar Artery Aneurysms with Flow Diversion.

Author information

1
Division of Neurointerventional Radiology, Neuroscience Institute, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA; Department of Radiology, University of Iowa Carver School of Medicine, Iowa City, Iowa, USA. Electronic address: adam.wallace@crlmed.com.
2
Mallinckrodt Institute of Radiology, Washington University, St. Louis, Missouri, USA.
3
Department of Radiology, Emory University, Atlanta, Georgia, USA.
4
Division of Neurointerventional Radiology, Neuroscience Institute, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA.
5
Mallinckrodt Institute of Radiology, Washington University, St. Louis, Missouri, USA; Department of Neurosurgery, Washington University, St. Louis, Missouri, USA; Department of Neurology, Washington University, St. Louis, Missouri, USA.
6
Department of Neurosurgery, Emory University, Atlanta, Georgia, USA.
7
Mallinckrodt Institute of Radiology, Washington University, St. Louis, Missouri, USA; Department of Neurosurgery, Washington University, St. Louis, Missouri, USA.
8
Department of Radiology, Emory University, Atlanta, Georgia, USA; Department of Neurosurgery, Emory University, Atlanta, Georgia, USA.

Abstract

BACKGROUND:

Flow diversion is a viable alternative for treatment of wide-neck and fusiform aneurysms originating from the posterior inferior cerebellar artery (PICA), but coverage of the PICA and vertebral perforating arteries may be a concern. The aim of this study was to examine procedural, clinical, and angiographic outcomes of patients with PICA aneurysms treated with the Pipeline Embolization Device.

METHODS:

Retrospective review was performed of PICA aneurysms treated with the Pipeline device at 3 neurovascular centers, including periprocedural complications and clinical and angiographic outcomes.

RESULTS:

In 16 procedures, 14 PICA aneurysms were treated with the Pipeline device. These included 11 saccular aneurysms with a mean size of 7.4 mm (range, 2.0-11.1 mm) and 3 fusiform aneurysms with a mean diameter of 6.1 mm (range, 5.0-8.0 mm) and mean length of 10.3 mm (range, 6.0-15.0 mm). One patient developed a PICA territory infarct with mild leg weakness that resolved in <7 days. Overall complication rate was 7% (1/14) per patient and 6% (1/16) per procedure. Mean duration of clinical follow-up was 13.5 months (range, 3 weeks to 61.7 months), with all patients returning to baseline functional status. Complete or near-complete aneurysm occlusion was achieved in 58% (7/12) of cases with angiographic follow-up (mean, 15 months; range, 4-61 months). All covered PICAs remained patent.

CONCLUSIONS:

Flow diversion of PICA aneurysms is a safe and viable treatment option when traditional endovascular options are unlikely to preserve parent vessel patency.

KEYWORDS:

Aneurysm; Angiography; Flow diverter; Hemorrhage; Stroke

PMID:
29548957
DOI:
10.1016/j.wneu.2018.03.036
[Indexed for MEDLINE]

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