Bilateral Approach for Stent-assisted Coiling of Posterior Inferior Cerebellar Artery Aneurysms: Two Cases.
10.7461/jcen.2012.14.3.223
- Author:
Se Il JEON
1
;
Bae Ju KWON
;
Dae Hee SEO
;
Hee In KANG
;
Sung Choon PARK
;
Il Seung CHOE
Author Information
1. Department of Neurosurgery, Myongji Hospital, Kwandong University College of Medicine, Goyang, Korea.
- Publication Type:Case Report
- Keywords:
Posterior inferior cerebellar artery;
Intracranial aneurysm;
Endovascular treatment
- MeSH:
Achievement;
Aneurysm;
Arteries;
Intracranial Aneurysm;
Pica;
Stents;
Vertebral Artery
- From:Journal of Cerebrovascular and Endovascular Neurosurgery
2012;14(3):223-227
- CountryRepublic of Korea
- Language:English
-
Abstract:
Aneurysms of the posterior inferior cerebellar artery (PICA) are rarely encountered. In particular, due to frequent anatomic complexity and the presence of nearby critical structures, PICA origin aneurysms are difficult to treat. However, recent reports of anecdotal cases using advanced endovascular instruments and skills have made the results of endovascular treatment rather outstanding. PICA preservation is the key to a successful endovascular treatment, based on the premise that a PICA origin aneurysm is well occluded. To secure PICA flow, stenting into the PICA would be the best method, however, it is nearly impossible technically via the ipsilateral vertebral artery (VA) if the PICA arose at an acute angle from the sac. In such a case, a bilateral approach for stent-assisted coiling can be a creative method for achievement of two goals of both aneurysm occlusion and PICA preservation: ipsilateral approach for coil delivery and contralateral cross-over approach for stent delivery via a retrograde smooth path into the PICA.
