Research ArticleOriginal Article
Open Access

Endovascular treatment of distal posterior inferior cerebellar artery aneurysms

Jun Tang, Linjie Wei, Lin Li, Yin Niu, Qianwei Chen, Hua Feng, Gang Zhu and Zhi Chen
Neurosciences Journal July 2016, 21 (3) 236-240; DOI: https://doi.org/10.17712/nsj.2016.3.20160076

Article Figures & Data

Figures

  • Figure 1
    Figure 1

    Endovascular treatment for a patient with a saccular-shaped aneurysm at the distal posterior inferior cerebellar artery (PICA) A) Three-dimensional angiogram of the right vertebral artery angiogram saccular-shaped aneurysm (arrow) at the distal PICA. B & C) Angiogram obtained immediately after embolization showing total occlusion of the aneurysm (arrow). B) unsubtracted angiogram and C) subtracted angiogram

  • Figure 2
    Figure 2

    Endovascular treatment for a patient with a fusiform aneurysm at the distal posterior inferior cerebellar artery (PICA). A) Left vertebral artery angiogram showing a fusiform aneurysm at the distal PICA associated with marked narrowing of the proximal PICA (arrow). B) Road mapping image showing difficulties in navigating the microguidewire and microcatheter through the narrowing segment of the proximal PICA (arrow). C) Angiogram obtained immediately after embolization showing complete occlusion of the aneurysm as well as the parent artery (arrow). D) Postoperative T2-weighted MRI demonstrating lateral-medullary infarction (arrow).

  • Figure 3
    Figure 3

    Endovascular treatment for a patient with a fusiform aneurysm at the distal posterior inferior cerebellar artery (PICA). A) Left vertebral artery angiogram showing a fusiform aneurysm (arrow) at the distal PICA. B) Road mapping image showing an exchange microguidewire navigated to the distal PICA through the tortuous left vertebral artery before coiling of the aneurysm. C) Fluoroscopic image showing the coil delivery in the fusiform dilation before the subsequent stent deployment. D) Angiogram obtained immediately after embolization showing the disappearance of the fusiform dilation and patency of the PICA (arrow).

  • Figure 4
    Figure 4

    Endovascular trapping for a patient with a fusiform aneurysm at the distal PICA A) Left vertebral artery angiogram showing a fusiform aneurysm (arrow) at the cortical segment of the posterior inferior cerebellar artery. B) Angiogram obtained immediately after embolization showing total occlusion of the aneurysm together with the involved branch.

Tables

  • Table 1

    Clinical characteristics of patients with distal aneurysms of the posterior inferior cerebellar artery.

    CaseAge/genderH-H GradeSite of the aneurysmShapeTreatmentImmediate resultComplications
    1.73/MILateral-medullarySaccularSelective coilingCompleteNone
    2.39/MIIIAnterior-medullaryFusiformTrappingCompleteLateral medulla oblongata infarct
    3.65/FIITonsillomedullarySaccularSelective coilingCompleteNone
    4.57/MIITelovelotonsillarFusiformTrappingCompleteUnilateral cerebellar infarcts
    5.56/FIIIAnterior-medullarySaccularStenting/coilingCompleteIntraoperative rupture
    6.68/MIVCorticalFusiformTrappingCompleteNone
    7.58/MIAnterior-medullarySaccularSelective coilingCompleteNone
    8.61/MIIITelovelotonsillarSaccularMicrocatheter protection/coilingCompleteNone
    9.42/MIILateral-medullaryFusiformTrappingCompleteNone
    10.55/MIIILateral-medullaryFusiformStenting/coilingNear completeNone
    11.57/FIICorticalFusiformTrappingCompleteUnilateral cerebellar infarcts
    12.61/FIITelovelotonsillarFusiformTrappingCompleteNone
    13.50/FIITelovelotonsillarSaccularSelective coilingCompleteNone

    • H-H grade - Hunt and Hess grade

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