Two Distally Located Right SCA Aneurysms: Endovascular Treatment by Parent Artery Occlusion with GDC Coils and N-BCA Injection

Peripheral aneurysms of the superior cerebellar artery are considered difficult to treat surgically and endovascularly because of their inaccessibility. Parent artery occlusion is therefore frequently the preferred method. Embolic materials previously reported in this situation are either GDC coils or a polymerizing agent (n-BCA). We report a patient with two distally located, wide-neck aneurysms of the right superior cerebellar artery who presented with hemorrhage and was treated by endovascular embolization of the parent artery using a combination of GDC coils and n-BCA.

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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

Surgical Neurology ◽

10.1016/j.surneu.2005.09.009 ◽

2006 ◽

Vol 65 (6) ◽

pp. 621-624 ◽

Cited By ~ 21

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

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

Journal of Clinical Imaging Science ◽

10.4103/2156-7514.99181 ◽

2012 ◽

Vol 2 ◽

pp. 47 ◽

Cited By ~ 9

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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Endovascular Treatment of AICA Flow Dependent Aneurysms

Interventional Neuroradiology ◽

10.1177/159101991201800411 ◽

2012 ◽

Vol 18 (4) ◽

pp. 449-457 ◽

Cited By ~ 6

Author(s):

M. Mahmoud ◽

A. El Serwi ◽

M. Alaa Habib ◽

S. Abou Gamrah

Keyword(s):

Cerebral Aneurysms ◽

Neurological Complications ◽

Artery Occlusion ◽

Endovascular Embolization ◽

Anterior Inferior Cerebellar Artery ◽

Parent Artery ◽

Parent Artery Occlusion ◽

Cerebellar Artery ◽

Liquid Embolic

Peripheral anterior inferior cerebellar artery (AICA) aneurysms are rare, accounting for less than 1% of all cerebral aneurysms. To our knowledge 34 flow-related cases including the present study have been reported in the literature. Three patients harbouring four flow dependent aneurysms were referred to our institution. Two patients presented with subarachnoid hemorrhage, one presented with cerebellar manifestations. They were all treated by endovascular embolization of the aneurysm as well as the parent artery using liquid embolic material. Two cases were embolized using NBCA, Onyx was used in the third case. No bleeding or rebleeding were encountered during the follow-up period which ranged from five to nine months. One patient developed facial palsy, cerebellar symptoms and sensorineural hearing loss. The remaining two cases did not develop any post treatment neurological complications. Endovascular management of flow-dependent AICA aneurysms by parent artery occlusion is feasible and efficient in terms of rebleeding prevention. Post embolization neurological complications are unpredictable. This depends upon the adequacy of collaterals from other cerebellar arteries.

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Endovascular Treatment of Giant P1/P2 Aneurysm by Direct Puncture of the Vertebral Artery

Interventional Neuroradiology ◽

10.1177/159101990300900405 ◽

2003 ◽

Vol 9 (4) ◽

pp. 359-365 ◽

Cited By ~ 3

Author(s):

M. Szajner ◽

K. Obsza_Ska ◽

A. Nestorowicz ◽

M. Szczerbo-Trojanowska ◽

T. Trojanowski

Keyword(s):

Vertebral Artery ◽

Artery Occlusion ◽

Endovascular Embolization ◽

Seldinger Technique ◽

Parent Artery ◽

Direct Puncture ◽

Femoral Approach ◽

Parent Artery Occlusion ◽

Transbrachial Approach ◽

The Right

Vascular access is usually achieved through a femoral arterial puncture using a modified Seldinger technique. However, selective catheterization of the great cerebral vessels by femoral approach fails completely when the vessel is tortuous or atheromatous. In case of posterior vascular circulation aneurysms, transbrachial approach or direct puncture of the vertebral artery (VA) is an alternative. The aneurysms of the posterior cerebral artery (PCA) are reported to be rare. Due to unfavorable anatomic location, the PCA aneurysms are difficult to reach during surgical procedure. Endovascular embolization is at present considered to be more effective and safer treatment of the PCA aneurysms arising from different segments, offering a viable alternative to the surgical approach. We report the case of the giant left PCA aneurysm, located at the junction of P1/P2 segments, successfully treated by parent artery occlusion achieved after the direct puncture of the right VA which was used because both VAs were tortuous, irregular and their ostia were not accessible by femoral approach. According to different authors, parent artery occlusion appears to be safe in the treatment of P2 segment aneurysms, whatever the location of the occlusion. In our case we decided to perform this kind of treatment believing it was the only possible one.

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Republished: Successful treatment of ruptured multiple fusiform middle cerebral artery aneurysms with silk vista baby flow diverter in a 10-months-old infant

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2021-017554.rep ◽

2021 ◽

pp. neurintsurg-2021-017554.rep

Author(s):

Giovanni Barchetti ◽

Loris Di Clemente ◽

Mauro Mazzetto ◽

Mariano Zanusso ◽

Paola Ferrarese ◽

...

Keyword(s):

Middle Cerebral Artery ◽

Cerebral Artery ◽

Successful Treatment ◽

Expectant Management ◽

Flow Diverter ◽

Artery Occlusion ◽

Parent Artery ◽

Microsurgical Clipping ◽

Parent Artery Occlusion ◽

The Right

We report the successful treatment of multiple ruptured fusiform middle cerebral artery (MCA) aneurysms in a 10-month-old girl. This previously healthy infant presented with subarachnoid haemorrhage and was found to have multiple irregular dilatations of the superior division branch of the right MCA. Cerebral angiography was performed and confirmed the presence of multiple fusiform aneurysms of the MCA. After multidisciplinary team discussion, it was decided to treat the aneurysms with endovascular approach, using a flow-diverter. Microsurgical clipping was deemed risky because of the high likelihood of parent artery occlusion and expectant management was also considered inappropriate because of the risk of re-bleeding. Dual antiplatelet therapy was started, and a flow-diverter was successfully delivered in the superior division branch of the right MCA. The post-operative course was uneventful, MRI at 12 months did not show any sign of recurrence and at 3 years of age the patient had a normal neurological examination.

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Parent Artery Occlusion for Intracranial Aneurysms

Interventional Neuroradiology ◽

10.1177/159101990901500308 ◽

2009 ◽

Vol 15 (3) ◽

pp. 309-315 ◽

Cited By ~ 5

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.

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Endovascular treatment of anterior inferior cerebellar artery trunk aneurysms

Interventional Neuroradiology ◽

10.1177/15910199211049054 ◽

2021 ◽

pp. 159101992110490

Author(s):

Kun Hou ◽

Kan Xu ◽

Jinlu Yu

Keyword(s):

Endovascular Treatment ◽

Collateral Circulation ◽

Artery Occlusion ◽

Anterior Inferior Cerebellar Artery ◽

Parent Artery ◽

Anatomical Location ◽

Parent Artery Occlusion ◽

Cerebellar Artery ◽

Reasonable Choice ◽

Perforating Arteries

Background The anterior inferior cerebellar artery (AICA) is a very slender and anatomically variable artery that gives off many important perforating arteries that feed the brainstem and nerve-related arteries that feed the inner ear and labyrinth. AICA trunk aneurysms are rare entities that are also difficult to manage. At present, endovascular treatment (EVT) is the preferred choice; however, the understanding of EVT for AICA trunk aneurysms is limited. Methods In this article, we present a literature review on EVT for AICA trunk aneurysms. To promote understanding, we would also provide some illustrative educational cases of our institute. Results Aneurysms along the AICA trunk can occur alone (isolated AICA aneurysm) or secondary to cerebrovascular shunts (flow-related AICA aneurysm). According to their anatomical location, they can also be divided into proximal and distal types. At present, EVT is the mainstream treatment, mainly including selective coiling with parent artery preservation and parent artery occlusion. Both coils and liquid embolization materials can be used. Conclusions For AICA trunk aneurysms, EVT is a reasonable choice and should be based on the specific anatomical location, pathology, and collateral circulation. However, there is still controversy as to the specific type of treatment that should be chosen.

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Balloon Migration into a Giant Carotid Aneurysm after Parent Artery Occlusion Using Detachable Balloons

Interventional Neuroradiology ◽

10.1177/159101999800400410 ◽

1998 ◽

Vol 4 (4) ◽

pp. 323-328 ◽

Cited By ~ 2

Author(s):

A. Uchino ◽

P.K. Maurer ◽

H.S. Brara ◽

Y. Numaguchi

Keyword(s):

Carotid Artery ◽

Internal Carotid Artery ◽

Internal Carotid ◽

Artery Occlusion ◽

Parent Artery ◽

Parent Artery Occlusion ◽

Occlusion Technique ◽

Large Aneurysm ◽

The Right

We treated a 70-year-old man with a giant paraophthalmic region aneurysm of the right internal carotid artery using the parent artery occlusion technique with three detachable balloons. Initially, the patient did well, but migration of the distal balloon into the aneurysm was detected seven months later. This report suggests that initial parent artery occlusion using balloons will not always induce permanent thrombosis of a large aneurysm, because the occlusion and thrombosis is strictly dependant on the position of the balloons that are used, and adjunct use of coils may be indicated.

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Treatment of vertebral artery aneurysms with transposition of the posterior inferior cerebellar artery to the vertebral artery combined with parent artery occlusion

Journal of Neurosurgery ◽

10.3171/jns.2006.105.5.781 ◽

2006 ◽

Vol 105 (5) ◽

pp. 781-784 ◽

Cited By ~ 11

Author(s):

Kuniaki Ogasawara ◽

Yoshitaka Kubo ◽

Nobuhiko Tomitsuka ◽

Masayuki Sasoh ◽

Yasunari Otawara ◽

...

Keyword(s):

Vertebral Artery ◽

Posterior Inferior Cerebellar Artery ◽

Artery Occlusion ◽

The Other ◽

Parent Artery ◽

Pica Pica ◽

Suboccipital Craniectomy ◽

Parent Artery Occlusion ◽

Cerebellar Artery ◽

Good Patency

✓ The authors describe transposition of the posterior inferior cerebellar artery (PICA) to the vertebral artery (VA) combined with parent artery occlusion for the treatment of VA aneurysms in cases in which a clip could not be applied because of the origin of the ipsilateral PICA. The aneurysm is trapped through a lower lateral suboccipital craniectomy. The PICA is then cut just distal to the aneurysm, and the PICA and VA proximal to the aneurysm are anastomosed in an end-to-end or end-to-side fashion. The surgical procedure was successfully performed in two patients, each of whom had hypoplastic occipital arteries (OAs). The PICA contralateral to the lesion was hypoplastic in one patient and distant to the ipsilateral PICA in the other patient. Mild transient dysphagia developed postoperatively in one patient due to glossopharyngeal and vagus nerve palsy, and the other patient had an uneventful postoperative course. In both patients, postoperative cerebral angiography demonstrated good patency of the transposed PICA. These results show that transposition of the PICA to the VA is a useful procedure for the reconstruction of the PICA when parent artery occlusion is necessary to exclude a VA aneurysm involving the origin of the PICA and when OA–PICA anastomosis or PICA–PICA anastomosis cannot be performed.

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