Posterior Inferior Cerebellar Artery Patency after Flow-Diverting Stent Treatment

AJNR Am J Neuroradiol. 2016 Mar;37(3):487-9. doi: 10.3174/ajnr.A4550. Epub 2015 Oct 1.

Abstract

Background and purpose: The rate of PICA occlusion after flow-diverting stent placement for vertebral and vertebrobasilar artery aneurysms is not known. The purpose of this study is to determine the medium-term rate of PICA patency and risk factors for occlusion after such aneurysm treatment.

Materials and methods: Patients were identified who had vertebral or vertebrobasilar artery aneurysms and who were treated by placing a flow-diverting stent across the PICA ostium. Demographic and procedural factors associated with stent placement were recorded. Patency of the PICA was evaluated immediately after stent placement and on follow-up angiography.

Results: Thirteen patients with vertebral or vertebrobasilar artery aneurysms were treated in the study period, of whom 4 presented with subarachnoid hemorrhage. The average number of devices that spanned the PICA ostium was 1.77 (range, 1-3), with no immediate PICA occlusions. There were no postoperative strokes in the treated PICA territory, although there was 1 contralateral PICA-territory stroke of unclear etiology without clinical sequelae. In 11 patients with follow-up angiography at a mean of 10.6 months (range, 0.67-27.9 months), the PICA patency rate remained 100%.

Conclusions: Flow-diverting stent placement across the PICA ostium in the treatment of vertebral and vertebrobasilar artery aneurysms may not result in immediate or midterm PICA occlusion.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Basilar Artery / surgery
  • Cerebral Angiography
  • Cerebral Arteries / diagnostic imaging*
  • Cerebral Arteries / surgery
  • Embolization, Therapeutic / instrumentation
  • Embolization, Therapeutic / methods
  • Female
  • Humans
  • Intracranial Aneurysm / diagnostic imaging*
  • Intracranial Aneurysm / therapy*
  • Male
  • Middle Aged
  • Stents
  • Subarachnoid Hemorrhage / epidemiology
  • Vascular Patency
  • Vertebral Artery / surgery