J Korean Neurosurg Soc.  2003 Nov;34(5):428-432.

Experience of Endovascular Treatment of Distal Posterior Cerebral Artery Aneurysms

• Yang JW
• You SH
• Hong SC
• Kim JS
• Roh HG
• Byun HS

Abstract

OBJECTIVE
Distal posterior cerebral artery(PCA) aneurysms requiring the problematic surgical approaches are rarely encountered. With the development of endovascular treatment, distal PCA aneurysms tend to be treated by endovascular method rather than surgery. We report our experience of distal PCA aneurysms, which were managed mainly by endovascular treatment. METHODS: During the last 5 years, there were five patients harboring distal PCA aneurysms(0.7% among a total 656 intracranial aneurysms). Four patients presented with subarachnoid hemorrhage, while one presented with ipsilateral facial hypesthesia. Four of them were treated by endovascular(Guglielmi detachable coil: GDC) embolization and one was treated by surgical clipping after failure of GDC embolization. RESULTS: Complete obliteration with parent artery encroachment was confirmed in 2 cases. There was one occipital lobe infarction and it resulted in the homonymous quadrantanopsia. In the other case, cerebral infarction did not develop. Incomplete coil embolization was inevitably performed to avoid parent artery occlusion in another two cases. CONCLUSION: Even with the obliteration of the parent artery, distal PCA aneurysms could be treated by use of GDC effectively. Adequate collateral supply to the distal arterial territory seems to contribute to it. Further study needs to be performed to verify this hypothesis.

Keyword

Posterior cerebral artery; Aneurysm; GDC embolization

MeSH Terms

Aneurysm
Arteries
Cerebral Infarction
Embolization, Therapeutic
Hemianopsia
Humans
Hypesthesia
Infarction
Intracranial Aneurysm*
Occipital Lobe
Parents
Passive Cutaneous Anaphylaxis
Posterior Cerebral Artery*
Subarachnoid Hemorrhage
Surgical Instruments