For saccular-shaped aneurysms with a favorable neck, selective aneurysmal coiling was attempted. Depending on the vascular anatomy and location of the aneurysms at the distal PICA, various therapeutic strategies were chosen including selective aneurismal coiling, parent artery occlusion, microcatheter-assisted coiling, and stent-assisted coiling. All of the procedures were performed via the transfemoral route.
In the present study, we report our experience with, and associated complications of endovascular treatment of distal PICA aneurysms.Įndovascular treatment was performed under general anesthesia, and systemic heparinization was administered during the procedure. Although endovascular embolization as an alternative treatment has been recommended as a primary option in treating PICA aneurysms by some authors recently, 1, 4 there is still controversy regarding therapeutic strategies and complications.
2- 5 However, surgical treatment for those aneurysms can carry a significant risk of morbidity due to the close relationship of PICA aneurysms with the brain stem and lower cranial nerves. 3 Traditionally, most cases have been treated surgically, including clipping, wrapping, or trapping with or without vascular anastomosis. 1- 3 These aneurysms usually arise at the vertebral artery (VA)-PICA junction, while distal PICA aneurysms only account for less than 30% of all PICA aneurysms. Cerebral aneurysms of the posterior inferior cerebellar artery (PICA) are rare, representing approximately 0.5-3% of all intracranial aneurysms.