The mid/long-term follow-up of endovascular treatment of dissecting aneurysms of the posterior cerebellar artery

Abstract

Objective To investigate the safety and efficacy of endovascular treatment of dissecting aneurysms of the posterior cerebellar artery (PCA). Methods We retrospectively analyzed 19 consecutive patients with 19 dissecting aneurysms of PCA who underwent endovascular treatment at Department of Neurosurgery, Tangdu Hospital, Air Force Military Medical University between July 2012 and June 2017. Among those, 9 cases received stent-assisted coiling, 2 cases received double stents implanting and 8 cases received occlusion of parent artery. The post-intervention results were evaluated by Raymond Classification. We followed up all cases after discharge by imaging and telephone. Telephone follow-up results were about the clinical outcome and DSA results were evaluated by Raymond Classification. Results All patients in this series were treated successfully. Following initial treatment, there were 11 cases that were graded as class Ⅰ, 5 as class Ⅱ and 3 as class Ⅲ based on Raymond classification. Hemorrhagic event of aneurysmal rupture occurred in 2 cases (1 case with secondary in-stent thrombosis) during treatment and secondary cerebral infarction occurred in 1 case after treatment. All of the 3 cases recovered well at discharge. All cases were followed up for 6-28 months (mean: 13.4±3.1 months). Two patients recovered well based on telephone follow-up. Follow-up imaging results were evaluated by Raymond scale in 17 cases, which reported class Ⅰ in 13 aneurysms, class Ⅱ in 2 aneurysms. The other 2 case with recurrence received second endovascular treatment and had no more recurrence during long-term follow-up. Conclusions The endovascular treatment of dissecting aneurysms of PCA at a single center seems satisfactory and the mid-long term follow-up results are favorable. The endovascular treatment of dissecting aneurysms of PCA seems safe and feasible, which still needs to be confirmed by longer follow-up and controlled studies with larger sample size. Key words: Aneurysm, dissecting; Posterior cerebral artery; Embolization, therapeutic; Follow-up studies; Treatment outcome