• World Neurosurg · Jan 2019

    Case Reports

    Endovascular Coiling of Ruptured Very Small Dissecting Fusiform Aneurysm of Posterior Inferior Cerebellar Artery with Parent Artery Preservation by Microcatheter Auto-Assistance.

    • Moisey Aronov, Maxim Mokin, Alexander Zelenkov, Konstantin Popugaev, Alan Tsarikaev, and Andrey Reutov.
    • Endovascular Division, State Research Center Burnasyan FMBC of the FMBA of Russia, Moscow, Russia. Electronic address: moiseyaronov@me.com.
    • World Neurosurg. 2019 Jan 1; 121: 152-155.

    BackgroundAneurysmal subarachnoid hemorrhage secondary to ruptured small dissecting fusiform aneurysms of the posterior inferior cerebellar artery (PICA) is rare and particularly challenging. Different treatment strategies have been reported in these rare cases. We report 2 patients treated with a novel endovascular approach.Case DescriptionTwo patients presented with subarachnoid hemorrhage secondary to very small (3 mm and 4 mm) ruptured fusiform aneurysms of the proximal section of the PICA trunk. Both patients were treated by coil embolization combined with parent artery preservation by microcatheter auto-assistance. Both coiling procedures were uneventful, and the patients remained asymptomatic. Long-term follow-up angiography in both patients showed complete occlusion of aneurysms with patency of PICA.ConclusionsThere is no single treatment strategy suitable for all PICA aneurysms. Our proposed method may be best applied to small dissecting fusiform aneurysms located on a small (≤1 mm in diameter) PICA distally to its origin.Copyright © 2018 Elsevier Inc. All rights reserved.

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