Treatment of ruptured fusiform aneurysm in the posterior cerebral artery with posterior cerebral artery-superior cerebellar artery anastomosis combined with parent artery occlusion: case report

2006 ◽  
Vol 65 (6) ◽  
pp. 621-624 ◽  
Author(s):  
Hideo Saito ◽  
Kuniaki Ogasawara ◽  
Yoshitaka Kubo ◽  
Nobuhiko Tomitsuka ◽  
Akira Ogawa
Keyword(s):  
Case Report ◽  
Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Artery Occlusion ◽  
Superior Cerebellar Artery ◽  
Parent Artery ◽  
Fusiform Aneurysm ◽  
Parent Artery Occlusion ◽  
Cerebellar Artery

scholarly journals A Combined Approach to Treatment of the Dissecting Middle Cerebral Artery Fusiform Aneurysm

2009 ◽  
Vol 15 (3) ◽  
pp. 349-354 ◽  
Author(s):  
T. Hrbáč ◽  
P. Drábek ◽  
P. Klement ◽  
V. Procházka
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Artery Occlusion ◽  
Parent Artery ◽  
Fusiform Aneurysm ◽  
Neurological Sequelae ◽  
Parent Artery Occlusion ◽  
Aneurysm Embolization ◽  
Mca Aneurysm ◽  
One Year

A fusiform aneurysm in the terminal M1 middle cerebral artery (MCA) segment was treated by a construction of a high-flow arterial extracranial-intracranial (EC-IC) bypass. Due to severe bypass vasospasms, local vasodilating agents together with percutaneous angioplasty and stent implantation were applied, but failed due to subsequent bypass occlusion. To remedy this complication a new bypass was created from a segment of the saphenous vein, followed by MCA aneurysm embolization and parent artery occlusion. One year after the surgery, the venous bypass remains patent and the aneurysm occluded, with the patient fully active, without any neurological sequelae.

scholarly journals Parent Artery Occlusion for Intracranial Aneurysms

2009 ◽  
Vol 15 (3) ◽  
pp. 309-315 ◽  
Author(s):  
Lishan Cui ◽  
Qiang Peng ◽  
Wenbo Ha ◽  
Dexiang Zhou ◽  
Yang Xu
Keyword(s):  
Cerebral Artery ◽  
Intracranial Aneurysms ◽  
Posterior Inferior Cerebellar Artery ◽  
Cerebral Aneurysms ◽  
Artery Occlusion ◽  
Anterior Inferior Cerebellar Artery ◽  
Parent Artery ◽  
Parent Artery Occlusion ◽  
Cerebellar Artery ◽  
Dissecting Aneurysms

Peripheral cerebral aneurysms are difficult to treat with preservation of the parent arteries. We report the clinical and angiographic outcome of 12 patients with cerebral aneurysms located peripherally. In the past five years, 12 patients, six females and six males, presented at our institution with intracranial aneurysms distal to the circle of Willis and were treated endovascularly. The age of our patients ranged from four to 58 years with a mean age of 37 years. Seven of the 12 patients had subarachnoid and/or intracerebral hemorrhage upon presentation. Two patients with P2 dissecting aneurysms presented with mild hemiparesis and hypoesthesia, one patient with a large dissecting aneurysm complained of headaches and two patients with M3 dissecting aneurysms had mild hemiparesis and hypoesthesia of the right arm. Locations of the aneurysms were as follows: posterior cerebral artery in seven patients, anterior inferior cerebellar artery in two, posterior inferior cerebellar artery in one, middle cerebral artery in two. Twelve patients with peripheral cerebral aneurysms underwent parent artery occlusion (PAO). PAO was performed with detachable coils. No patient developed neurologic deficits. Distally located cerebral aneurysms can be treated with parent artery occlusion when selective embolization of the aneurysmal sac with detachable platinum coils or surgical clipping cannot be achieved.

scholarly journals Endovascular treatment of posterior cerebral artery aneurysms: a single center's experience of 55 cases

2017 ◽  
Vol 126 (4) ◽  
pp. 1094-1105 ◽  
Author(s):  
Xuanfeng Qin ◽  
Feng Xu ◽  
Yashengjiang Maimaiti ◽  
Yongtao Zheng ◽  
Bin Xu ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Case Series ◽  
Artery Occlusion ◽  
Dissecting Aneurysm ◽  
Attractive Alternative ◽  
Parent Artery ◽  
Parent Artery Occlusion

OBJECTIVE Aneurysms of the posterior cerebral artery (PCA) are uncommon. To date, a limited number of studies have examined the outcomes of endovascular treatment for PCA aneurysms. The authors' aim in this study is to report their experience with the endovascular treatment of PCA aneurysms. METHODS Between January 2007 and December 2014, 55 patients with 59 PCA aneurysms were treated using the endovascular approach at the authors' institution. Twenty-three patients had 25 saccular aneurysms, and 32 patients had 34 fusiform/dissecting aneurysms. The endovascular modalities included the following: 1) selective occlusion of the aneurysm (n = 22); 2) complete occlusion of the aneurysm and the parent artery (n = 20); 3) parent artery occlusion (n = 6); 4) partial coiling of the aneurysm and the parent artery (n = 5); and 5) occlusion of the dissecting aneurysm sac (n = 2). RESULTS The immediate angiographic results included 45 complete occlusions (82%), 2 nearly complete occlusions (4%), and 8 incomplete occlusions (14%). The mean follow-up period of 21.8 months in 46 patients showed 37 stable results, 6 further thromboses, and 3 recurrences. The final results included 41 complete occlusions (89%), 2 nearly complete occlusions (4%), and 3 incomplete occlusions (7%). Procedure-related complications included the following: 1) rebleeding (n = 1); 2) infarction (n = 4); and 3) perforation (n = 1). There was 1 (1.8%) procedure-related death due to rebleeding, and 2 (3.6%) non–procedure-related deaths due to severe subarachnoid hemorrhage. Clinical outcomes were excellent (Glasgow Outcome Scale 5) in 47 of 49 patients at the long-term follow-up. CONCLUSIONS PCA aneurysms may be effectively treated by different endovascular approaches with favorable clinical and radiological outcomes. However, patients who present with severe SAH still have an overall poor prognosis. Partial coiling of the aneurysm and the parent artery is an attractive alternative treatment for patients who may not tolerate parent artery occlusion. Further study with a larger case series is necessary for validation of the durability and efficacy of this treatment.

GIANT FUSIFORM ANEURYSM ARISING FROM FENESTRATED POSTERIOR CEREBRAL ARTERY AND BASILAR TIP VARIATION

Neurosurgery ◽  
2009 ◽  
Vol 64 (3) ◽  
pp. E564-E565 ◽  
Author(s):  
Marco A. Zanini ◽  
Vitor M. Pereira ◽  
Mauricio Jory ◽  
José G.M.P. Caldas
Keyword(s):  
Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Superior Cerebellar Artery ◽  
Fusiform Aneurysm ◽  
Parent Vessel ◽  
Vessel Occlusion ◽  
Cerebellar Artery ◽  
Parent Vessel Occlusion ◽  
The Right ◽  
Double Origin

Abstract OBJECTIVE A giant fusiform aneurysm in the posterior cerebral artery (PCA) is rare, as is fenestration of the PCA and basilar apex variation. We describe the angiographic and surgical findings of a giant fusiform aneurysm in the P1–P2 PCA segment associated with PCA bilateral fenestration and superior cerebellar artery double origin. CLINICAL PRESENTATION A 26-year-old woman presented with a 2-month history of visual blurring. Digital subtraction angiography showed a giant (2.5 cm) fusiform PCA aneurysm in the right P1–P2 segment. The 3-dimensional view showed a caudal fusion pattern from the upper portion of the basilar artery associated with a bilateral long fenestration of the P1 and P2 segments and superior cerebellar artery double origin. INTERVENTION Surgical trapping of the right P1–P2 segment, including the posterior communicating artery, was performed by a pretemporal approach. Angiograms performed 3 and 13 months after surgery showed complete aneurysm exclusion, and the PCA was permeated and filled the PCA territory. Clinical follow-up at 14 months showed the patient with no deficits and a return to normal life. CONCLUSION To our knowledge, this is the first report of a giant fusiform aneurysm of the PCA associated with P1–P2 segment fenestration and other variations of the basilar apex (bilateral superior cerebellar artery duplication and caudal fusion). Comprehension of the embryology and anatomy of the PCA and its related vessels and branches is fundamental to the decision-making process for a PCA aneurysm, especially when parent vessel occlusion is planned.

Endovascular parent artery occlusion of proximal posterior cerebral artery aneurysms: a report of two cases

2015 ◽  
Vol 8 (6) ◽  
pp. 591-593
Author(s):  
Hidenori Oishi ◽  
Shunsuke Tanoue ◽  
Kosuke Teranishi ◽  
Hiroshi Hasegawa ◽  
Senshu Nonaka ◽  
...  
Keyword(s):  
Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Artery Occlusion ◽  
Parent Artery ◽  
Parent Artery Occlusion ◽  
Thalamic Infarction ◽  
Perforating Arteries

We report two cases of proximal posterior cerebral artery (PCA) aneurysms treated with endovascular parent artery occlusion (PAO) with coils. In both cases, selective injection from the 4 F distal access catheter clearly showed the perforating arteries arising from the PCA. Case No 1, a 49-year-old woman, was successfully treated with preservation of a paramedian artery. Case No 2, a 54-year-old woman, was treated in the same manner. The patient underwent extensive thalamic infarction after the procedure because of paramedian artery occlusion. Endovascular PAO with coils is feasible for proximal PCA aneurysms; however, preservation of perforating arteries arising from the PCA is mandatory.

Endovascular parent artery occlusion in large-giant or fusiform distal posterior cerebral artery aneurysms

2002 ◽  
Vol 44 (8) ◽  
pp. 700-705 ◽  
Author(s):  
Anil Arat ◽  
Civan Islak ◽  
Isil Saatci ◽  
Naci Kocer ◽  
Saruhan Cekirge
Keyword(s):  
Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Artery Occlusion ◽  
Parent Artery ◽  
Parent Artery Occlusion

scholarly journals Endovascular Management of Fusiform Superior Cerebellar Artery Aneurysms: A Series of Three Cases with Review of Literature

2012 ◽  
Vol 2 ◽  
pp. 47 ◽  
Author(s):  
Anand Alurkar ◽  
Lakshmi Sudha P. Karanam ◽  
Suresh Nayak ◽  
Sagar Oak
Keyword(s):  
Artery Occlusion ◽  
Superior Cerebellar Artery ◽  
Endovascular Coiling ◽  
Parent Artery ◽  
Rare Entity ◽  
Endovascular Management ◽  
Review Of Literature ◽  
Parent Artery Occlusion ◽  
Cerebellar Artery ◽  
Feasible Option

Distal superior cerebellar artery (SCA) aneurysms are rare. Fusiform aneurysms of SCA are rarer and more challenging to treat. Parent artery occlusion by endovascular coiling is the treatment option for these cases. Presence of good collateral circulation and paucity of perforators from S1 and S2 segments makes this a feasible option. From 2007 to 2010, we treated three patients (two men and one woman between the ages of 42 to 64 years) with distal fusiform SCA aneurysms using endovascular coiling. All the patients presented with symptoms of rupture and were treated in the acute phase. Informed and written high-risk consent was given by all patients prior to the procedure. Successful angiographic and clinical outcome was achieved in all three patients. Endovascular treatment of fusiform SCA aneurysms with coils is a safe and feasible option in the management of this rare entity.

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