Re-growth of a Thrombosed Vertebral Artery Aneurysm after Endovascular Parent Artery Occlusion : A Case Report

Dissecting vertebral artery (VA) aneurysms are difficult to obliterate when the parent artery cannot be safely occluded. In this video, we demonstrate a combined microsurgical and endovascular treatment technique for a ruptured, dissecting VA aneurysm incorporating the origin of the posterior inferior cerebellar artery (PICA). We first performed a PICA-PICA side-to-side bypass to preserve flow through the right PICA. An endovascular approach was then utilized to embolize the proximal portion of the aneurysm from the right VA and the distal portion of the aneurysm from the left VA.The video can be found here: http://youtu.be/dkkKsX2BiJI.

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Treatment of Unruptured Vertebral Artery Aneurysm Involving Posterior Inferior Cerebellar Artery With Pipeline Embolization Device

Frontiers in Neurology ◽

10.3389/fneur.2021.622457 ◽

2021 ◽

Vol 12 ◽

Author(s):

Weiqi Fu ◽

Huijian Ge ◽

Gang Luo ◽

Xiangyu Meng ◽

Jiejun Wang ◽

...

Keyword(s):

Vertebral Artery ◽

Posterior Inferior Cerebellar Artery ◽

Artery Aneurysm ◽

Artery Occlusion ◽

Parent Artery ◽

Pipeline Embolization Device ◽

Complete Occlusion ◽

Parent Artery Occlusion ◽

Cerebellar Artery

Background: Treatment of unruptured vertebral artery aneurysm involving posterior inferior cerebellar artery (PICA) is challenging. The experience of pipeline embolization device (PED) therapy for these lesions is still limited.Objective: To evaluate the safety and efficacy of the PED for unruptured vertebral artery aneurysm involving PICA.Methods: Thirty-two patients with unruptured vertebral artery aneurysm involving PICA underwent treatment with PED were retrospectively identified. Procedure-related complications, PICA patency, clinical, and angiographic outcomes were analyzed.Results: Thirty-two aneurysms were successfully treated without any procedure-related complications. Images were available in 30 patients (93.8%) during a period of 3–26 months follow-up (average 8.4 months), which confirmed complete occlusion in 17 patients (56.5%), near-complete occlusion in 9 patients (30%), and incomplete occlusion in one patient (3.3%). Parent artery occlusion (PAO) was occurred in 3 patients (10%). Twenty-eight of 30 PICA remained patent. The two occlusions of PICA were secondary to PAO. At a mean of 20.7 months (range 7–50 months) clinical follow-up, all the patients achieved a favorable outcome without any new neurological deficit.Conclusion: PED seems to be a safe and effective alternative endovascular option for patients with unruptured vertebral artery aneurysm involving PICA.

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Parent Artery Occlusion for Treatment of a Traumatic Pericallosal Artery Aneurysm: Case Report and Review of the Literature

World Neurosurgery ◽

10.1016/j.wneu.2020.04.186 ◽

2020 ◽

Vol 140 ◽

pp. 193-197

Author(s):

Yuichiro Tsuji ◽

Takanori Miki ◽

Hiroto Kakita ◽

Kimitoshi Sato ◽

Takashi Yoshida ◽

...

Keyword(s):

Case Report ◽

Artery Aneurysm ◽

Artery Occlusion ◽

Parent Artery ◽

Review Of The Literature ◽

Pericallosal Artery ◽

Parent Artery Occlusion

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Ruptured Vertebral Artery Dissecting Aneurysm Associated With Parent Artery Occlusion-Case Report-

Neurologia medico-chirurgica ◽

10.2176/nmc.43.298 ◽

2003 ◽

Vol 43 (6) ◽

pp. 298-300 ◽

Cited By ~ 4

Author(s):

Kyoji SAKAI ◽

Masahiro KAMEDA ◽

Takaho TANIMOTO ◽

Kaoru TERASAKA ◽

Hiroshi SUGATANI ◽

...

Keyword(s):

Case Report ◽

Vertebral Artery ◽

Artery Occlusion ◽

Dissecting Aneurysm ◽

Parent Artery ◽

Parent Artery Occlusion ◽

Vertebral Artery Dissecting Aneurysm

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Hemifacial spasm caused by vertebral artery aneurysm treated by endovascular coil embolization

Surgical Neurology International ◽

10.25259/sni_564_2020 ◽

2020 ◽

Vol 11 ◽

pp. 431

Author(s):

Yu Iida ◽

Kentaro Mori ◽

Yosuke Kawahara ◽

Issei Fukui ◽

Katsuya Abe ◽

...

Keyword(s):

Vertebral Artery ◽

Hemifacial Spasm ◽

Coil Embolization ◽

Posterior Inferior Cerebellar Artery ◽

Artery Aneurysm ◽

Artery Occlusion ◽

Parent Artery ◽

Aneurysm Neck ◽

Parent Artery Occlusion ◽

Endovascular Coil Embolization

Background: Hemifacial spasm (HFS) caused by vertebral artery (VA) aneurysms is rare. Several cases of HFS caused by VA aneurysms treated by endovascular parent artery occlusion (PAO) have been reported. Recently, we treated a rare case of HFS caused by a saccular VA aneurysm at the bifurcation of the posterior inferior cerebellar artery (PICA), which was successfully treated by endovascular coil embolization, preserving the parent artery, and PICA. We discuss endovascular treatment for HFS induced by VA aneurysms with a literature review. Case Description: A 59-year-old man presented with the left HFS persisting for 2 months. Magnetic resonance imaging revealed a left saccular VA-PICA aneurysm and demonstrated that a left facial nerve was compressed by the aneurysm at the root exit zone. Angiography revealed that the PICA was branching from the aneurysm neck. Endovascular coil embolization was performed using the balloon remodeling technique to preserve the left VA and PICA. HFS disappeared after treatment. Conclusion: Although microvascular decompression was commonly accepted for the standard treatment of HFS, coil embolization of aneurysms without PAO may be an effective treatment for HFS caused by VA aneurysms.

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