Endovascular treatment of posterior cerebral artery aneurysms using detachable coils.
BACKGROUND
Aneurysms of the posterior cerebral artery (PCA) are rare, and most of the studies reported in the literature in which the endovascular approach was applied were carried out on a limited number of patients with PCA aneurysms. We retrospectively reviewed our cases of PCA aneurysms--at various locations and of differing shapes--that received endovascular treatment and evaluated the treatment outcome.


METHODS
From January 1996 to December 2006, 13 patients (eight females and five males) with 17 PCA aneurysms (nine fusiform and eight saccular) were treated using the endovascular approach. The age of the patients ranged from 20 to 67 years, with a mean age of 44 years. Of the 13 patients, ten presented with intracranial hemorrhage, and one patient, with a large P2 aneurysm, presented with trigeminal neuralgia; the aneurysms were asymptomatic in the remaining two patients.


RESULTS
All 13 patients were successfully treated, with only one procedure-related symptomatic complication. Seven patients were treated by occlusion of the aneurysm and parent artery together; five patients, by selective embolization of the aneurysm; one patient, by partial coiling. Although infarctions were found in two patients treated with selective embolization and in three patients treated with parent artery occlusion, only one patient with a ruptured P2 aneurysm treated with parent artery occlusion developed transient amnesia as an ischemic symptom.


CONCLUSIONS
Posterior cerebral artery aneurysms can be treated safely with either occlusion of the aneurysm together with the PCA or with a selective coil embolization. Infarctions may occur after endovascular treatment, but they are rarely the cause of a disabling symptom.
Roh
Hong Gee
HG
Department of Radiology, Kangwon National University Hospital, 17-1 Hyoja 3-dong, Chuncheon, Kangwon-do 200-947, South Korea.
Kim
Sam Soo
SS
Han
Heon
H
Kang
Hyun-Seung
HS
Moon
Won-Jin
WJ
Byun
Hong Sik
HS
D000328:Adult; D000368:Aged; D017542:Aneurysm, Ruptured / Q000175:diagnosis / Q000628:therapy*; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome