Endovascular Treatment of Posterior Inferior Cerebellar Artery Aneurysms with Flow Diversion

Adam N. Wallace, Mudassar Kamran, Thomas P. Madaelil, Yasha Kayan, Joshua W. Osbun, Anil K. Roy, Josser E.Delgado Almandoz, Christopher J. Moran, Brian M. Howard, Junaid Yasin, Jonathan A. Grossberg

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Background: Flow diversion is a viable alternative for treatment of wide-neck and fusiform aneurysms originating from the posterior inferior cerebellar artery (PICA), but coverage of the PICA and vertebral perforating arteries may be a concern. The aim of this study was to examine procedural, clinical, and angiographic outcomes of patients with PICA aneurysms treated with the Pipeline Embolization Device. Methods: Retrospective review was performed of PICA aneurysms treated with the Pipeline device at 3 neurovascular centers, including periprocedural complications and clinical and angiographic outcomes. Results: In 16 procedures, 14 PICA aneurysms were treated with the Pipeline device. These included 11 saccular aneurysms with a mean size of 7.4 mm (range, 2.0–11.1 mm) and 3 fusiform aneurysms with a mean diameter of 6.1 mm (range, 5.0–8.0 mm) and mean length of 10.3 mm (range, 6.0–15.0 mm). One patient developed a PICA territory infarct with mild leg weakness that resolved in <7 days. Overall complication rate was 7% (1/14) per patient and 6% (1/16) per procedure. Mean duration of clinical follow-up was 13.5 months (range, 3 weeks to 61.7 months), with all patients returning to baseline functional status. Complete or near-complete aneurysm occlusion was achieved in 58% (7/12) of cases with angiographic follow-up (mean, 15 months; range, 4–61 months). All covered PICAs remained patent. Conclusions: Flow diversion of PICA aneurysms is a safe and viable treatment option when traditional endovascular options are unlikely to preserve parent vessel patency.

Original languageEnglish
Pages (from-to)e581-e587
JournalWorld neurosurgery
StatePublished - Jun 2018


  • Aneurysm
  • Angiography
  • Flow diverter
  • Hemorrhage
  • Stroke


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