Clinical evaluation of endovascular treatment of posterior inferior cerebellar artery (PICA) aneurysms

Year 2018, , 327 - 330, 28.12.2018

Gürdal Orhan , Ergün Dağlıoğlu

https://doi.org/10.18663/tjcl.496682

Abstract

Aim: PICA
aneurysms are rare. A significant proportion of the patients present with
hemorrhage. Endovascular treatment is replacing the surgical treatment
particularly within the last two decades. Anatomical difficulties of the PICA
origin is the reason of disfficulties in surgical and endovascular treatment
options.

Material and Methods: In
the present study, clinical and angiographical analysis of 17 patients with
PICA aneurysms whom were treated at Ankara Numune Education and Research
Hospital between 2014 and 2018 were analyzed.

Results: Of
17 patients 15 were female and two of them were male. Four patients had
associated aneurysms at other intracranial localizations. Aneurysms were
saccular in 13 and fusiform dissecting in 4 patients. Mean diameter of the
aneurysms was 8.5 mm in fusiform dissecting type and 11.4 mm in saccular type.
Primary coiling was performed in 2, stent assisted coiling in 5 and flow
diverter treatment was primary treatment modality in 10 patients.  

Conclusion: In
the present study of 17 PICA aneurysms, flow diverters were the main treatment
modality among endovascular treatment options with improved clinical results. 

Keywords

PICA aneurysm, endovascular treatment, flow diverters, angiography

Endovasküler tedavi uygulanan posterior inferior serebellar arter (PICA) anevrizmalarının klinik değerlendirilmesi

Abstract

Amaç: PICA
(posterior inferior serebellar arter) anevrizmaları nadir intrakranial
anevrizmalar olup olguların önemli bir kısmı kanama ile prezente olur. Özellikle
son iki dekadda PICA anevrizmalarının tedavisinde daha çok endovasküler
yöntemler öne çıkmaktadır. PICA orijininin anatomik yapısından dolayı
endovasküler ve cerrahi tedavide güçlükler yaşanmaktadır.

Gereç ve Yöntemler: Bu
çalışmada Ankara Numune Eğitim ve Araştırma Hastanesinde 2014-2018 yılları
arasında endovasküler yöntemlerle tedavi edilen 17 PICA anevrizma olgusunun klinik
ve anjiyografik özellikleri incelenmektedir.

Bulgular: Toplam
17 olgunun 15’i bayan 2’si erkek olup yaş ortalamaları 53.5 olarak tespit
edilmiştir. Dört olguda eşlik eden diğer inrakranial lokalizasyonlarda
anevrizmaya rastlanmıştır. Olguların dördünde anevrizma fuziform disekan tipte
iken diğer 13 olguda anevrizma saküler tipte idi. Fuziform disekan
anevrizmaların çap ortalamaları 8.5 mm iken saküler tip anevrizmaların çap
ortalaması ise 11.4 mm idi. Toplam 2 olguda primer koilleme yapılırken, 5
olguda stent eşliğinde koilleme ve ikisi çift seans olmak üzere toplam 10
olguda akım yönlendiriciler tedavide kullanılmıştır.

Sonuç: Bu
çalışmada PICA anevrizması nedeni ile tedavi edilen 17 olguda sıklıkla akım
yönlendiricilerin tercih edildiği endovasküler tedaviler ile başarılı klinik
sonuçlar elde edilmiştir. 

Keywords

PICA anevrizması, endovasküler tedavi, akım yönlendiriciler, anjiyografi

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