Endovascular treatment of superior cerebellar artery aneurysms

Abstract

AIM: To present our experience on superior cerebellar artery (SCA) aneurysms treated with embolization by using current endovascular techniques. MATERIAL and METHODS: All SCA aneurysms treated by our endovascular team since 2013 were retrospectively evaluated. Clinical information and angiographic findings on presentation, during treatment and on follow-up were noted. RESULTS: Endovascular treatment was the primary treatment method for SCA aneurysms during the study period. Twenty three patients (15 female, 8 male) with a mean age of 50.6 years, 12 of whom with subarachnoid hemorrhage were treated. Treatments included coiling (56%), stent assisted coiling, stentriever assisted coiling, Y stent assisted coiling and flow diversion with either flow diverter placement or telescopic stenting. Two patients died secondary to consequences of subarachnoid hemorrhage. The outcome of 1 patient was Modified Rankin Scale (mRS) 3 and the outcome of remaining 20 patients was mRS 0. The rates of aneurysm occlusion according to Raymond-Roy classification were: class 1 in 11 patients, class 2 in 6 patients and class 3 in 2 patients on a mean follow-up of 15.3 months. Only one patient required retreatment. CONCLUSION: Current endovascular techniques are able to address the high rate of recanalization and retreatment of SCA aneurysms which are currently the major drawbacks associated with primary coiling when compared with surgical treatment. It remains to be shown if use of these latest techniques are associated with increased risk of thromboembolic events.

Management of saccular superior cerebellar artery aneurysms: The Buffalo experience case series and systematic review

“…Each study provided follow-up data with the lowest mean follow-up being 15.3 months. 5,6,11,12,14 Most articles presented clinical outcome by use of the Glasgow Outcome Scale (GOS), whereas Acik et al used the mRS, similar to our study. 5,6,11,12,14 All articles provided enough data to calculate a Raymond-Roy occlusion classification scale (Table 4).…”

Treatment of Unique Bilateral Distal Fusiform Superior Cerebellar Artery Aneurysms with Mini-Flow Diverter Device Implantation: Case Report

“…The radiologic outcome of FDD treatment in SCA aneurysms is unfortu-nately difficult to assess because of inconsistent reporting throughout the previous studies. [4][5][6][7][8][9][10][11] Strikingly, in no case postinterventional cerebellar ischemia was reported. 4,[6][7][8][9][10][11] The risk of late ischemic complications, however, still need to be evaluated.…”

Successful use of an LVIS device to treat unruptured distal aneurysm of the superior cerebellar artery at a vascular bifurcation

“…To the best of our knowledge, 12 such cases have been reported [ Table 1 ]. [ 1 , 4 - 10 , 12 , 14 ] The stents used were the Pipeline (PED; Medtronic, Dublin, Ireland), the Flow-Redirection Endoluminal Device Jr (MicroVention), the SILK FD (Balt Extrusion, Montmorency, France), the Low-profile Visualized Intraluminal Support device Jr (MicroVention), and the p64 flow modulation device (phenox GmbH, Germany). The LVIS used to treat our patient was not used in any of those reported cases.…”

“…[ 2 ] Treatment options for SCA aneurysms include endovascular treatment and open surgery,[ 3 ] but reports of the use of flow diverters (FDs) started to appear in 2013. [ 1 , 4 - 10 , 12 , 14 ] Unlike conventional endovascular treatment devices, FDs do not require insertion of a catheter into the aneurysm to deposit coils or other embolic material, but instead represent innovative devices that restrict blood flow into the aneurysm, thus sparing the parent vessel while preventing aneurysm rupture or growth. [ 11 ]…”