scholarly journals Endovascular Occlusion of the Posterior Cerebral Artery in the Treatment of P2 Ruptured Aneurysms

2007 ◽  
Vol 13 (2) ◽  
pp. 127-132 ◽  
Author(s):  
E. Cotroneo ◽  
R. Gigli ◽  
G. Guglielmi
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Endovascular Treatment ◽  
Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Parent Vessel ◽  
Ruptured Aneurysms ◽  
Endovascular Occlusion ◽  
Platinum Coils

Four cases of posterior cerebral artery (PCA) aneurysms are described. The aneurysms were located at the P2 segment of PCA. All cases presented with a subarachnoid hemorrhage (SAH). Endovascular treatment was performed, with occlusion of the aneurysm and parent vessel, using platinum coils. Two patients developed a homonymus lateral hemianopia after treatment.

Competitive flow diversion of multiple P1 aneurysms: proposed classification

2020 ◽  
Vol 13 (6) ◽  
pp. e015581
Author(s):  
Mark Alexander MacLean ◽  
Thien J Huynh ◽  
Matthias Helge Schmidt ◽  
Vitor M Pereira ◽  
Adrienne Weeks
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cerebral Artery ◽  
Internal Carotid ◽  
Posterior Cerebral Artery ◽  
Flow Diversion ◽  
Endovascular Coiling ◽  
Ruptured Aneurysms ◽  
The Right

We report the case of a patient with subarachnoid hemorrhage and three aneurysms arising from the posterior communicating artery (Pcomm)-P1 complex, treated with endovascular coiling and competitive flow diversion. The largest and likely ruptured Pcomm aneurysm was treated with traditional coiling. Two smaller potentially ruptured aneurysms arose from the distal right posterior cerebral artery (PCA) P1 segment. After a failed attempt to treat with conventional flow diversion across the PCA-P1 segment, the P1 aneurysms were successfully treated with competitive flow diversion distal to the PCA-P1 segment from Pcomm to the P2 segment. Over 12 months, competitive flow diversion redirected flow to the right PCA territory via the internal carotid artery-Pcomm-P2, reducing the size of the PCA-P1 segment and obliterating the P1 aneurysms. Competitive flow diversion treatment should be considered for aneurysms occurring at the circle of Willis when traditional methods are not feasible. Herein, we introduce a novel classification for competitive flow diversion treatment.

Republished: Treatment of wide-necked basilar tip aneurysm not amenable to Y-stenting using the PulseRider device

2015 ◽  
Vol 8 (9) ◽  
pp. e37-e37 ◽  
Author(s):  
Sunil A Sheth ◽  
Nirav S Patel ◽  
Ameera F Ismail ◽  
Dena Freeman ◽  
Gary Duckwiler ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Parent Vessel ◽  
Basilar Tip Aneurysm

Endovascular treatment of broad-necked bifurcation aneurysms remains challenging. Stent-assisted coiling has been successful but requires catheterization of the branches off the parent vessel. We present the case of a patient who failed primary and stent-assisted coiling of a large basilar tip aneurysm because the morphology of the aneurysm precluded successful distal catheterization of the posterior cerebral artery (PCA) branches. Using the PulseRider device, which does not require catheterization of bifurcation branches, we were able to treat the aneurysm successfully.

Republished: Competitive flow diversion of multiple P1 aneurysms: proposed classification

2020 ◽  
Vol 12 (9) ◽  
pp. e7-e7
Author(s):  
Mark Alexander MacLean ◽  
Thien J Huynh ◽  
Matthias Helge Schmidt ◽  
Vitor M Pereira ◽  
Adrienne Weeks
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cerebral Artery ◽  
Internal Carotid ◽  
Posterior Cerebral Artery ◽  
Flow Diversion ◽  
Endovascular Coiling ◽  
Ruptured Aneurysms ◽  
The Right

We report the case of a patient with subarachnoid hemorrhage and three aneurysms arising from the posterior communicating artery (Pcomm)-P1 complex, treated with endovascular coiling and competitive flow diversion. The largest and likely ruptured Pcomm aneurysm was treated with traditional coiling. Two smaller potentially ruptured aneurysms arose from the distal right posterior cerebral artery (PCA) P1 segment. After a failed attempt to treat with conventional flow diversion across the PCA-P1 segment, the P1 aneurysms were successfully treated with competitive flow diversion distal to the PCA-P1 segment from Pcomm to the P2 segment. Over 12 months, competitive flow diversion redirected flow to the right PCA territory via the internal carotid artery-Pcomm-P2, reducing the size of the PCA-P1 segment and obliterating the P1 aneurysms. Competitive flow diversion treatment should be considered for aneurysms occurring at the circle of Willis when traditional methods are not feasible. Herein, we introduce a novel classification for competitive flow diversion treatment.

Subarachnoid Hemorrhage due to Rupture of Infundibular Dilation of a Circumflex Branch of the Posterior Cerebral Artery

Neurosurgery ◽  
1994 ◽  
Vol 34 (6) ◽  
pp. 1075-1077 ◽  
Author(s):  
George Koike ◽  
Kyoji Seguchi ◽  
Kazuhiko Kyoshima ◽  
Shigeaki Kobayashi
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cerebral Artery ◽  
Posterior Cerebral Artery

Acute occlusion of the fetal posterior cerebral artery: diagnosis and management paradigms

2021 ◽  
pp. 197140092110193
Author(s):  
Mohamad Abdalkader ◽  
Anurag Sahoo ◽  
Julie G Shulman ◽  
Elie Sader ◽  
Courtney Takahashi ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Cerebral Artery ◽  
Mechanical Thrombectomy ◽  
Posterior Cerebral Artery ◽  
Management Strategies ◽  
Artery Occlusion ◽  
Large Vessel ◽  
Large Vessel Occlusion ◽  
Vessel Occlusion ◽  
Cerebral Artery Occlusion

Background and purpose The diagnosis and management of acute fetal posterior cerebral artery occlusion are challenging. While endovascular treatment is established for anterior circulation large vessel occlusion stroke, little is known about the course of acute fetal posterior cerebral artery occlusions. We report the clinical course, radiological findings and management considerations of acute fetal posterior cerebral artery occlusion stroke. Methods We performed a retrospective review of consecutive patients presenting with acute large vessel occlusion who underwent cerebral angiogram and/or mechanical thrombectomy between January 2015 and January 2021. Patients diagnosed with fetal posterior cerebral artery occlusion were included. Demographic data, clinical presentation, imaging findings and management strategies were reviewed. Results Between January 2015 and January 2021, three patients with fetal posterior cerebral artery occlusion were identified from 400 patients who underwent angiogram and/or mechanical thrombectomy for acute stroke (0.75%). The first patient presented with concomitant fetal posterior cerebral artery and middle cerebral artery occlusions. Thrombectomy was performed with recanalisation of the fetal posterior cerebral artery but the patient died from malignant oedema. The second patient presented with isolated fetal posterior cerebral artery occlusion. No endovascular intervention was performed and the patient was disabled from malignant posterior cerebral artery infarct. The third patient presented with carotid occlusion and was found to have fetal posterior cerebral artery occlusion after internal carotid artery recanalisation. No further intervention was performed. The patient was left with residual contralateral homonymous hemianopia and mild left sided weakness. Conclusion Fetal posterior cerebral artery occlusion is a rare, but potentially disabling, cause of ischaemic stroke. Endovascular treatment is feasible. Further investigation is needed to compare the efficacy of medical versus endovascular management strategies.

Traumatic dissecting pathology of posterior cerebral artery: a report of two cases—aneurysm and pial arteriovenous fistula

2021 ◽  
Vol 14 (5) ◽  
pp. e237722
Author(s):  
Vignesh Selvamurugan ◽  
Surya Nandan Prasad ◽  
Vivek Singh ◽  
Zafar Neyaz
Keyword(s):  
Arteriovenous Fistula ◽  
Cerebral Artery ◽  
Road Traffic ◽  
Posterior Cerebral Artery ◽  
Case Reports ◽  
Dissecting Aneurysm ◽  
Parent Vessel ◽  
Vessel Occlusion ◽  
Parent Vessel Occlusion ◽  
Pial Arteriovenous Fistula

We present two cases of 17-year-old man and 10-year-old boy presenting with subarachnoid haemorrhage and a history of road traffic accident. One patient had dissecting aneurysm of the posterior cerebral artery (PCA), and the other patient had partially thrombosed aneurysm on CT angiography. On digital subtraction angiography of the second patient, there was formation of PCA pontomesencephalic vein pial arteriovenous fistula (PAVF). Both the patients underwent endovascular treatment: stent-assisted coiling for aneurysm and coiling with parent vessel occlusion for PAVF. There were no procedural complications. Follow-up angiography showed no residual aneurysm or fistula. Trauma is one of the recognised causes of dissection, and intracranial dissections can present as stenotic lesions, aneurysms or fistulas, depending on the pathology. Traumatic dissecting PCA aneurysm has been reported in only two case reports previously, and post-traumatic PAVF in PCA has not been reported.

Endovascular Treatment of Complex Distal Posterior Cerebral Artery Aneurysms with the Pipeline Embolization Device

2017 ◽  
Vol 107 ◽  
pp. 1043.e1-1043.e5 ◽  
Author(s):  
Paul Mazaris ◽  
Tapan Mehta ◽  
Mohammed Hussain ◽  
Violiza Inoa ◽  
Justin Singer ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Pipeline Embolization Device

Beware of Nihilism: Favorable Outcome despite Poor Admission Status in Posterior Circulation Aneurysms after Aneurysmal Subarachnoid Hemorrhage

2021 ◽  
Author(s):  
Nina Brawanski ◽  
Sepide Kashefiolasl ◽  
Sae-Yeon Won ◽  
Joachim Berkefeld ◽  
Elke Hattingen ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Mortality Rate ◽  
Cerebral Artery ◽  
Coil Embolization ◽  
Posterior Inferior Cerebellar Artery ◽  
Posterior Circulation ◽  
Anterior Circulation ◽  
Ruptured Aneurysms ◽  
Admission Status ◽  
Posterior Circulation Aneurysms

Abstract Objective As shown in a previous study, aneurysm location seems to influence prognosis in patients with subarachnoid hemorrhage (SAH). We compared patients with ruptured aneurysms of anterior and posterior circulation, undergoing coil embolization, concerning differences in outcome and prognostic factors. Methods Patients with SAH were entered into a prospectively collected database. We retrospectively identified 307 patients with aneurysms of the anterior circulation (anterior cerebral artery, carotid bifurcation, and middle cerebral artery) and 244 patients with aneurysms of the posterior circulation (aneurysms of the basilar artery, posterior inferior cerebellar artery, posterior communicating artery and posterior cerebral artery). All patients underwent coil embolization. The outcome was assessed using the modified Rankin Scale (mRS; favorable [mRS 0–2] vs. unfavorable [mRS 3–6]) 6 months after SAH. Results In interventionally treated aneurysms of the anterior and posterior circulation, statistically significant risk factors for poor outcome were worse admission status and severe cerebral vasospasm. If compared with patients with ruptured aneurysms of the anterior circulation, patients with aneurysms of the posterior circulation had a significantly poorer admission status, and suffered significantly more often from an early hydrocephalus. Nonetheless, there were no differences in outcome or mortality rate between the two patient groups. Conclusion Patients with a ruptured aneurysm of the posterior circulation suffer more often from an early hydrocephalus and have a significantly worse admission status, possibly related to the untreated hydrocephalus. Nonetheless, the outcome and the mortality rate were comparable between ruptured anterior and posterior circulation aneurysms, treated by coil embolisation. Therefore, despite the poorer admission status of patients with ruptured posterior circulation aneurysms, treatment of these patients should be considered.

Endovascular therapy for posterior communicating artery-infundibular dilatation aneurysms

2021 ◽  
Vol 7 (6) ◽  
pp. 6511-6518
Author(s):  
Xinggen Fang ◽  
Degang Wu ◽  
Niansheng Lai ◽  
Jinlong Yuan ◽  
Zhenbao Li ◽  
...  
Keyword(s):  
Cerebral Artery ◽  
Endovascular Therapy ◽  
Internal Carotid ◽  
Posterior Cerebral Artery ◽  
Posterior Communicating Artery ◽  
Vertebral Angiography ◽  
Ruptured Aneurysms ◽  
Aneurysm Embolization ◽  
Lost To Follow Up

Objective: The purpose of this study was to explore the effect of endovascular therapy on posterior communicating artery-infundibular dilatation aneurysms. Methods: A total of 15 patients with ruptured aneurysms caused by posterior communicating artery-infundibular dilatation who were treated in our neurosurgical center from January 2015 to December 2018were included in this study. They were performed with bilateral internal carotid angiography and vertebral angiography and treated with endovascular method. The modified Rankin Scale (mRS) was used for clinical follow-up for 18 months. Results: There were 10 patients in the posterior communicating artery-infundibular dilatation aneurysms with non-fetal posterior cerebral artery. Among them, 8 patients were treated with coil-alone embolization. Immediate imaging showed infundibular dilation residual in 6 cases and no contrast filling in either infundibular dilation or aneurysm in 2 case. Another 2 were treated with stent-assisted coiling embolization, and immediate imaging showed no contrast filling. Of the 5 patients in posterior communicating artery-infundibular dilatation aneurysms with fetal posterior cerebral artery, 4 were only coiled in the aneurysm sack with contrast filling in infundibular cones, and 2 were treated with stent assisted coiling. Among the 10 patients with non-fetal posterior cerebral artery, 3 showed recurrence, 4 showed stable images, 2 were also stable with no contrast filling in infundibular dilation or aneurysm and 1 was lost to follow-up. Among the 5 patients with fetal posterior cerebral artery, 1 showed stable images, 3 showed recurrence and 1 was lost to follow-up. Conclusions: For posterior communicating artery-infundibular dilatation aneurysms with non-fetal posterior cerebral artery, stent-assisted coiling of aneurysm embolization combined with occlusion of cones is effective to prevent or reduce recurrence.

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