医学
小脑后下动脉
小脑前下动脉
动脉瘤
小脑动脉
Pica(排版)
放射科
椎动脉
基底动脉
小脑上动脉
外科
梭形动脉瘤
万维网
计算机科学
作者
Jerry C. Ku,Vishal Chavda,Paolo Palmisciano,Christopher R. Pasarikovski,Victor X. D. Yang,Ruba Kiwan,Stefano M. Priola,Bipin Chaurasia
出处
期刊:Journal of Cerebrovascular and Endovascular Neurosurgery
[Korean Society of Cerebrovascular Surgeons/Korean Society of Endovascular Surgery]
日期:2023-04-12
卷期号:25 (4): 452-461
被引量:4
标识
DOI:10.7461/jcen.2023.e2022.10.011
摘要
The Anterior Inferior Cerebellar Artery-Posterior Inferior Cerebellar Artery (AICA-PICA) common trunk is a rare variant of cerebral posterior circulation in which a single vessel originating from either the basilar or vertebral arteries supplies both cerebellum and brainstem territories. We present the first case of an unruptured right AICA-PICA aneurysm treated with flow diversion using a Shield-enhanced pipeline endovascular device (PED, VANTAGE Embolization Device with Shield Technology, Medtronic, Canada). We expand on this anatomic variant and review the relevant literature. A 39-year-old man presented to our treatment center with vertigo and right hypoacusis. The initial head CT/CTA was negative, but a 4-month follow-up MRI revealed a 9 mm fusiform dissecting aneurysm of the right AICA. The patient underwent a repeat head CTA and cerebral angiogram, which demonstrated the presence of an aneurysm on the proximal portion of an AICA-PICA anatomical variant. This was treated with an endovascular approach that included flow diversion via a PED equipped with Shield Technology. The patient's post-procedure period was uneventful, and he was discharged home after two days with an intact neurological status. The patient is still asymptomatic after a 7-month follow-up, with MR angiogram evidence of stable aneurysm obliteration and no ischemic lesions. Aneurysms of the AICA-PICA common trunk variants have a high morbidity risk due to the importance and extent of the territory vascularized by a single vessel. Endovascular treatment with flow diversion proved to be both safe and effective in obliterating unruptured cases.
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