Posterior Inferior Cerebellar Artery Patency after Flow-Diverting Stent Treatment

Levitt, Michael R.; Park, M. S.; Albuquerque, Felipe C; Moon, Karam; Kalani, M. Yashar S.; McDougall, Cameron G.

doi:10.3174/ajnr.a4550

Cited by 31 publications

(19 citation statements)

References 22 publications

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“…10,30 Importantly, small branching feeders off the parent artery appear to remain intact even when covered by telescoping flow diverters, making these diverters especially useful when treating tandem aneurysms separated by a longer distance. 4,11,14,26,30 We successfully deployed 25 PEDs to treat 38 tandem aneurysms in 17 patients. The average Raymond score at the last follow-up was 1.3, and 89% of treated aneurysms had complete occlusion at the last follow-up.…”

Section: Discussionmentioning

confidence: 99%

Flow diversion of tandem cerebral aneurysms: a multi-institutional retrospective study

Awad

Moon

Yoon

et al. 2017

Neurosurgical Focus

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OBJECTIVEFlow diversion has proven to be an efficacious means of treating cerebral aneurysms that are refractory to other therapeutic means. Patients with tandem aneurysms treated with flow diversion have been included in larger, previously reported series; however, there are no dedicated reports on using this technique during a single session to treat this unique subset of patients. Therefore, the authors analyzed the outcomes of patients who had undergone single-session flow diversion for the treatment of tandem aneurysms.METHODSThe authors conducted a retrospective review of flow diversion with the Pipeline embolization device (PED) for the treatment of tandem aneurysms in a single session at 2 participating medical centers: University of Utah, Salt Lake City, Utah, and Barrow Neurological Institute, Phoenix, Arizona. Patient demographic data, aneurysm characteristics, treatment strategy and results, complications, and follow-up data were collected from the medical record and analyzed.RESULTSBetween January 2011 and December 2015, 17 patients (12 female, 5 male) with a total of 38 aneurysms (mean size 4.7 ± 2.7 mm, mean ± SD) were treated. Sixteen patients had aneurysms in the anterior circulation, and 1 patient had tandem aneurysms in the posterior circulation. Twelve patients underwent only placement of a PED, whereas 5 underwent adjunctive coil embolization of at least 1 aneurysm. One PED was used in each of 9 patients, and 2 PEDs were required in each of 8 patients. There were 2 intraprocedural complications; however, in both instances, the patients were asymptomatic at the last follow-up. The follow-up imaging studies were available for 15 patients at a mean of 7 months after treatment (216 days, range 0–540 days). The mean initial Raymond score after treatment was 2.7 ± 0.7, and the mean final score was 1.3 ± 0.7.CONCLUSIONSIn this series, the use of flow diversion for the treatment of tandem cerebral aneurysms had an acceptable safety profile, indicating that it should be considered as an effective therapy for this complicated subset of patients. Further prospective studies must be performed before more definitive conclusions can be made.

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Section: Discussionmentioning

confidence: 99%

Flow diversion of tandem cerebral aneurysms: a multi-institutional retrospective study

Awad

Moon

Yoon

et al. 2017

Neurosurgical Focus

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“…5,17,18,28,36 However, recent experiences reported a 0% rate of branch occlusion in the posterior circulation on immediate or follow-up angiography. 14,20,22 Mazur and colleagues' series specifically reported the patency of PICA and aneurysm occlusion on angiography. VA included fusiform aneurysms (80%).…”

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confidence: 99%

Endovascular management of fusiform aneurysms in the posterior circulation: the era of flow diversion

Awad

Mascitelli

Haroun

et al. 2017

Neurosurgical Focus

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Fusiform aneurysms are uncommon compared with their saccular counterparts, yet they remain very challenging to treat and are associated with high rates of rebleeding and morbidity. Lack of a true aneurysm neck renders simple clip reconstruction or coil embolization usually impossible, and more advanced techniques are required, including bypass, stent-assisted coiling, and, more recently, flow diversion. In this article, the authors review posterior circulation fusiform aneurysms, including pathogenesis, natural history, and endovascular treatment, including the role of flow diversion. In addition, the authors propose an algorithm for treatment based on their practice.

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“…PICA receives many sources of collateral flow that affects treatment,11 15 16 especially with regards to maintaining supply to the perforating vessels of the anterior and lateral medullary segments and irrigating PICA territory in cases of occlusion at the origin or distally 17…”

Section: Discussionmentioning

confidence: 99%

Flow diversion for the treatment of posterior inferior cerebellar artery aneurysms: a novel classification and strategies

Srinivasan

Ghali

Reznik

et al. 2017

J NeuroIntervent Surg

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Posterior Inferior Cerebellar Artery Patency after Flow-Diverting Stent Treatment

Cited by 31 publications

References 22 publications

Flow diversion of tandem cerebral aneurysms: a multi-institutional retrospective study

Flow diversion of tandem cerebral aneurysms: a multi-institutional retrospective study

Endovascular management of fusiform aneurysms in the posterior circulation: the era of flow diversion

Flow diversion for the treatment of posterior inferior cerebellar artery aneurysms: a novel classification and strategies

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