Experience of Endovascular Treatment of Distal Posterior Cerebral Artery Aneurysms

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.