Parent artery occlusion for treatment of posterior cerebral artery dissecting aneurysms

Abstract

Objective To study the safety and efficacy of parent artery occlusion for the treatment of posterior cerebral artery dissecting aneurysms.Methods 23 patients with posterior cerebral artery dissecting aneurysms were treated via endovascular parent artery occlusion in our institution.All of the aneurysms were at P2 or distal segment of PCA.Glasgow Outcome Scale (GOS) was used to evaluate the clinical outcome.Results The procedure was technically suocessful in all cases.Four procedure-related complications occurred:rebleeding ( n =1 ),hemiparesis ( n =1 ),and hemianopisia ( n =2).In the trapping group and the proximal occlusion group,all of the immediate angiography showed occlusion of the parent vessel and the aneurysm without retrograde filling from collateral vessels.And follow-up imaging showed no recurrence of the aneurysms.In the palliative embolization group,one of five patients was died of rebleeding after the procedure.The follow-up DSA showed that the other four aneurysms recurred.Conclusions Deliberate parent artery occlusion with detachable coils appears to be well tolerated for P2 or distal segment of PCA dissecting aneurysms.The technique may be the first choice of treatment for the treatment of dissecting aneurysms ofposterior cerebral artery. Key words: Posterior cerebral artery; Aneurysm; Parent artery occlusion