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 AICA Flow Dependent Aneurysms

2012 ◽  
Vol 18 (4) ◽  
pp. 449-457 ◽  
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.

Endovascular treatment for ruptured vertebral dissecting aneurysms involving PICA: Reconstruction or deconstruction? Experience from 16 patients

2020 ◽  
pp. 159101992097003
Author(s):  
Xiangjie Kong ◽  
Zeyu Sun ◽  
Chenhan Ling ◽  
Liang Xu ◽  
Cong Qian ◽  
...  
Keyword(s):  
Posterior Inferior Cerebellar Artery ◽  
Artery Occlusion ◽  
Parent Artery ◽  
First Line ◽  
Optimal Method ◽  
Parent Artery Occlusion ◽  
Cerebellar Artery ◽  
Proximal Occlusion ◽  
Dissecting Aneurysms

Objective Ruptured vertebral dissecting aneurysms (VDAs) with posterior inferior cerebellar artery (PICA) involved require an optimal method to isolate the dissection and prevent the symptomatic infraction. This study aims to present our experience with both parent artery occlusion (PAO) and stent-assisted coiling (SAC), and provide a favorable strategy to the management of ruptured VDAs with PICA involved. Methods We retrospectively reviewed patients with subarachnoid hemorrhage in our database from March 2013 to December 2018, suffering from dissecting aneurysms of the intradural vertebral arteries and endovascularly treated. A total of 16 cases with PICA involved were included. Basic information, aneurysm characteristics, procedure related complications and outcomes of patients were analyzed. Results 10 (62.5%) aneurysms were managed with PAO containing 3 proximal occlusion and 8 targeted-trapping preserved the PICA. 5 (31.3%) aneurysms were treated with SAC and one 6.3%) treated with vertebral artery to PICA stenting and trapping. Two (12.5%) patients died in the acute phase. Good clinical outcomes (modified Rankin Scale 0 to 3) were observed in 13(81.5%) cases in 30 days follow-up. PICA territory infraction was happened in one patient without any dysfunction. Favorable occlusion was observed in 9 of 12 (75%) which were free of further treatment. Conclusions For patients with good contralateral circulation, PAO could be a first line management for ruptured VDAs with PICA involved. Targeted-trapping with either reserved PICA or proximal occlusion with moderate coiling in aneurysm are promising modalities to prevent severe PICA infraction.

Endovascular treatment of anterior inferior cerebellar artery trunk aneurysms

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.

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

2006 ◽  
Vol 105 (5) ◽  
pp. 781-784 ◽  
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.

Giant fusiform intracranial aneurysms: review of 120 patients treated surgically from 1965 to 1992

1997 ◽  
Vol 87 (2) ◽  
pp. 141-162 ◽  
Author(s):  
Charles G. Drake ◽  
Sydney J. Peerless
Keyword(s):  
Intracranial Aneurysms ◽  
Cerebral Aneurysms ◽  
Mass Effect ◽  
Artery Occlusion ◽  
Parent Artery ◽  
Anterior Circulation ◽  
Content Type ◽  
Parent Artery Occlusion ◽  
Collateral Vessels ◽  
Proximal Occlusion

✓ The paucity of information about giant fusiform intracranial aneurysms prompted this review of 120 surgically treated patients. Twenty-five aneurysms were located in the anterior and 95 in the posterior circulation. Six patients suffered from atherosclerosis and only three others had a known arteriopathy. The remaining 111 patients presented with aneurysms resulting from an unknown arterial disorder; these patients were much younger than those harboring atherosclerotic aneurysms. Mass effect occurred in only 50% of cases and hemorrhage in 20%. Eight aneurysms caused transient ischemic attacks. Hunterian proximal occlusion or trapping were dominant among the treatment methods. In contrast to the management of giant saccular aneurysms, the usual thrombotic occlusion of a giant fusiform aneurysm after proximal parent artery occlusion requires the presence of two collateral circulations to prevent infarction, one for the end vessels and another for the perforating vessels that arise from the aneurysm. Although there was some reliance on the circle of Willis and on collateral vessels manufactured at surgery, the extent of natural leptomeningeal and perforating collateral, thalamic, lenticulostriate, and brainstem vessels was astonishing and formerly unknown to the authors. Good outcome occurred in 76% of patients with aneurysms in the anterior circulation; two of the six cases with poor results included patients who were already hemiplegic. Ninety percent of patients with posterior cerebral aneurysms fared well. Only 67% of patients with basilar or vertebral aneurysms had good outcomes, although more (17%) of these patients were in poor condition preoperatively because of brainstem compression.

Parent Artery Occlusion for Peripheral Anterior Inferior Cerebellar Artery Aneurysm

2008 ◽  
Vol 21 (2) ◽  
pp. 261-265 ◽  
Author(s):  
Xianli Lv ◽  
Youxiang Li ◽  
Aihua Liu ◽  
Jingbo Zhang ◽  
Zhongxue Wu
Keyword(s):  
Artery Aneurysm ◽  
Artery Occlusion ◽  
Anterior Inferior Cerebellar Artery ◽  
Parent Artery ◽  
Parent Artery Occlusion ◽  
Cerebellar Artery

scholarly journals Stent-Jack Technique for Ruptured Vertebral Artery Dissecting Aneurysm Involving the Origin of Posterior Inferior Cerebellar Artery

2020 ◽  
Vol 15 (2) ◽  
pp. 84-88
Author(s):  
Toshitsugu Terakado ◽  
Yasunobu Nakai ◽  
Go Ikeda ◽  
Kazuaki Tsukada ◽  
Sho Hanai ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Posterior Inferior Cerebellar Artery ◽  
Artery Occlusion ◽  
Dissecting Aneurysm ◽  
Parent Artery ◽  
Careful Attention ◽  
Parent Artery Occlusion ◽  
Cerebellar Artery ◽  
Vertebral Artery Dissecting Aneurysm ◽  
Vertebral Artery Stenting

We herein report a case of a ruptured vertebral artery dissecting aneurysm involving the origin of the posterior inferior cerebellar artery that was treated using the stent-jack technique. After parent artery occlusion of the distal vertebral artery, stenting of the posterior inferior cerebellar artery was performed. Further coiling was needed because distal vertebral artery recanalization occurred due to transformation of the coil mass. The stent-jack technique for a ruptured vertebral artery dissecting aneurysm involving the origin of the posterior inferior cerebellar artery is effective; however, careful attention to recanalization after stenting is needed due to transformation of the coil mass.

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