Safety and efficacy of treatment strategies for posterior inferior cerebellar artery aneurysms: a systematic review and meta-analysis

Abstract

Our meta-analysis demonstrated that both treatment modalities are technically feasible with high rates of technical success and effective with sufficient long-term aneurysm occlusion rates. Our data suggest that surgery is associated with superior angiographic outcomes. While endovascular therapy could be a reasonable first-line treatment option for proximal PICA aneurysms, surgery remains a highly effective first-line choice for distal PICA aneurysms. These findings should be considered when deciding the best therapeutic strategy.

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

“…In approaching PICA aneurysms, our initial treatment algorithm35 starts with well accepted modalities with proven success 36. When established modalities did not seem optimal, due to patient factors, preference, or surgeon comfort, FD was brought up as an option and discussed.…”

“…For type 1a (proximal, saccular) aneurysms, which often require assisted coiling, a retrograde access technique may be employed, providing a superior angle for stent or balloon deployment 39. Petr et al , in their recent review, demonstrate the variety of treatment strategies for these aneurysms 36. Their meta-analysis of 796 aneurysms across 29 studies found that 56.8% were treated surgically and endovascularly for the remainder.…”

Surgical Management and Outcomes of Aneurysms of Posterior Inferior Cerebellar Artery: Location-Based Approaches with Review of Literature

“…Sejkorová et al 38 also reported their series of 81 cases of PICA aneurysms during a 15-year period and found more recurrences in the coiled group. A meta-analysis by Petr et al 39 of 796 PICA aneurysmal cases comparing clipping and coiling has shown PICA Aneurysms: An Overview Deora et al…”

Surgical treatment of a posterior inferior cerebellar artery aneurysm via transcranial neuroendoscopic approach

“…[1–3] Although aneurysms can occur anywhere from the VA-PICA junction to the distal cortical branches of the PICA, most of them occur in the proximal segment of the PICA, especially at the VA-PICA junction. The management of these PICA aneurysms is challenging due to their proximity to the lower cranial nerve, high risk of rebleeding, and the presence of critical perforators supplying the medulla; these aneurysms are usually treated by both microsurgical treatments and endovascular treatments (EVT).…”