Coil Embolization of Ruptured Proximal Posterior Inferior Cerebellar Artery Aneurysm with Contralateral Retrograde Approach for LVIS Jr. Intraluminal Support Deployment
10.7461/jcen.2018.20.4.235
- Author:
Dong Sub KIM
1
;
Jae Hoon SUNG
;
Dong Hoon LEE
;
Ho Jun YI
Author Information
1. Department of Neurosurgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea. jaehoonsung@gmail.com
- Publication Type:Case Report
- Keywords:
Stents;
Vertebral artery;
Subarachnoid hemorrhage;
Embolization
- MeSH:
Aneurysm;
Aneurysm, Dissecting;
Arteries;
Constriction, Pathologic;
Embolization, Therapeutic;
Humans;
Middle Aged;
Pica;
Punctures;
Stents;
Subarachnoid Hemorrhage;
Thrombosis;
Vertebral Artery
- From:Journal of Cerebrovascular and Endovascular Neurosurgery
2018;20(4):235-240
- CountryRepublic of Korea
- Language:English
-
Abstract:
The safety and feasibility of simple coil embolization and stent deployment for the treatment of posterior inferior cerebellar artery (PICA) aneurysms, as well as their radiologic and clinical results, have not been adequately understood. Especially, if dissecting aneurysm of proximal PICA is associated with small caliber PICA and stenosis of ipsilateral vertebral artery orifice (VAO), endovascular coiling with saving of PICA is not always easy. This 64-year-old man presented with subarachnoid hemorrhage due to a ruptured dissecting aneurysm of left proximal PICA. The aneurysm was irregularly fusiform in nature with a shallow PICA orifice (1.4 mm) and narrow caliber (0.9–1.5 mm). Moreover, the ipsilateral VAO showed severe stenosis (1.8 mm). We performed bifemoral puncture and chose additional route from right vertebral artery to left vertebrobasilar junction for retrograde approach and deployment of LVIS Jr. intraluminal support at proximal PICA. And then, the antegrade approach and coiling of aneurysm was done. Despite of transient thrombus of PICA, the aneurysm was successfully secured with preservation of whole PICA course. For preservation of narrow PICA with ipsilateral VAO stenosis, the contralateral approach and deployment of LVIS Jr. intraluminal support may be considered.
