J Korean Soc Radiol.  2016 Apr;74(4):230-235. 10.3348/jksr.2016.74.4.230.

Distal Posterior Cerebral Artery Aneurysms: Retrospective Review of Characteristics and Endovascular Treatment

• Baek JW
• Seung WB
• Jeong HW

• KMID: 2208780
• DOI: http://doi.org/10.3348/jksr.2016.74.4.230

Abstract

PURPOSE
The objective of this study was to review the clinical outcome after treatment of distal posterior cerebral artery (PCA) aneurysms via endovascular approach.
MATERIALS AND METHODS
Eleven patients with 11 distal PCA aneurysms who were treated via endovascular approach in Inje University Busan Paik Hospital and Kosin University Gospel Hospital from December 2002 to December 2013 were retrospectively reviewed.
RESULTS
Among the 11 patients, there were 3 males (27.3%) and 8 females (72.7%). The mean age was 56.6 years (range 44-72 years) and the mean aneurysm size was 8.45 mm (3-30 mm). Four (36.4%) aneurysms were located in the P2 segment, 6 (54.5%) in the P3 segment and 1 (9.1%) in the P1/2 junction. Seven (63.6%) aneurysms were treated with preservation of the parent artery; and the remaining 4 (36.4%) aneurysms were treated with parent artery occlusion. After treatment, the overall complication rate was 27% with the morbidity rate of 9.1% and the mortality rate of 18%.
CONCLUSION
Endovascular treatment of distal PCA aneurysm might be used to minimize neurologic deficit, considering the diverse and rich collaterals of posterior cerebral artery.

MeSH Terms

Aneurysm
Arteries
Busan
Endovascular Procedures
Female
Humans
Intracranial Aneurysm*
Male
Mortality
Neurologic Manifestations
Parents
Passive Cutaneous Anaphylaxis
Posterior Cerebral Artery*
Retrospective Studies

Figure

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  Fig. 1 Successful embolization was done by using parent artery occlusion technique in a 59-year-old female who presented with subarachnoid and intraventricular hemorrhage (patient number 10 in Table 1). A. Initial non-contrast enhanced computed tomography scan shows diffuse subarachnoid hemorrhage with bilateral intraventricular hemorrhage. B, C. The anteroposterior (B) and lateral (C) projection views of a left vertebral artery angiography show a fusiform dissecting aneurysm (arrow) with ruptured state in the left P3 segment. D. Parent artery occlusion (arrow) technique was used for complete embolization.

• 

  Fig. 2 A saccular dissecting aneurysm at the right P2 segment in a 61-year-old female patient who presented with headache (patient number 3 in Table 1). A. The anteroposterior projection of right vertebral artery angiography shows a saccular dissecting aneurysm (arrow) in the right P2 segment. B. After selective coil embolization, complete aneurysmal occlusion (arrow) was conducted without parent artery occlusion.

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