J Neurointerv Surg 7:641–645, 2015, Arat A, Islak C, Saatci I, Kocer N, Cekirge S: Endovascular parent artery occlusion in large-giant or fusiform distal posterior cerebral artery aneurysms. Please allow up to 2 business days for review, approval, and posting. Aneurysms involving the posterior cerebral artery (PCA) are relatively rare, accounting for approximately 0.7% to 2.3% of all intracranial aneurysms.13,15,18,35 Surgical treatment of PCA aneurysms is complicated and often associated with high rates of morbidity because of the complexity of the perforating branches from the PCA and their relationship with the cranial nerves and upper brainstem.6,22,32,33 Selective catheterization of the PCA and endovascular occlusion of the aneurysm is technically feasible, offering an alternative to surgical treatment.7,21,29,35 For fusiform distal PCA aneurysms, parent artery occlusion (PAO) can be performed due to good collateralization.2,9,17,30 However, fusiform aneurysms involving the proximal segment (P1 and P1/P2 junction) or with a fetal-type PCA remain challenging.26,40 Moreover, published studies on PCA aneurysms treated by the endovascular approach comprise only a limited number of cases. The smallest length of the parent artery was nearly completely occluded. Reconstruction of the parent artery with flow-diverting (Silk) stent, Surpass flow diverter in the treatment of intracranial aneurysms: a prospective multicenter study, Stent-assisted reconstructive endovascular repair of cranial fusiform atherosclerotic and dissecting aneurysms: long-term clinical and angiographic follow-up, Endovascular treatment of complex intracranial aneurysms using intra/extra-aneurysmal stent, Fetal-type posterior cerebral artery: the pitfall of parent artery occlusion for ruptured P, Microsurgical anatomy of the posterior cerebral artery, Patients With Fusiform/Dissecting Aneurysms, Top 25 Cited Gamma Knife® Surgery Articles - Trigeminal Neuralgia, Top 25 Cited Gamma Knife® Surgery Articles - Volume 111, Volume 126 (2017): Issue 4 (Apr 2017): Pages 1029-A1444, Department of Neurosurgery, Huashan Hospital, Shanghai Medical School, Fudan University, Shanghai, China. Flow-diverting stents are new devices designed to treat complex intracranial aneurysms. We reported the clinical presentations, characteristics, endovascular treatments, complications, and angiographic and clinical outcomes of PCA aneurysms. The P1 segment was absent on the vertebral angiogram. Gradual thrombosis in the aneurysm may provide a time window for collateral progression. Second, no flow diverters were used in our series. Three of the 41 patients with PCA stroke (7.3%) presented with aggressive behavior (3 men, … E: A 4.5 × 22–mm Enterprise stent was deployed in the right P2 segment (arrow) and extended down to the mid-basilar artery (arrow). Right internal carotid angiography demonstrated collateral filling of the PCA segments distal to the occlusion. Your stroke treatment begins the moment emergency medical services (EMS) arrives to take you to the hospital. J Neurosurg 123:906–914, 2015, Zeal AA, Rhoton AL Jr: Microsurgical anatomy of the posterior cerebral artery. Moreover, BOT in the tortuous PCA is technically challenging, increasing the risk of procedure-related complications. The mean follow-up period of 21.8 months in 46 patients showed 37 stable results, 6 further thromboses, and 3 recurrences. The immediate angiographic results in our patients included 45 complete occlusions (82%), 2 nearly complete occlusions (4%), and 8 incomplete occlusions (14%). The immediate angiographic results showed complete occlusion in 21 (91.3%) patients, and nearly complete occlusion in 2 (8.7%) patients. [ncbi.nlm.nih.gov] G: Postoperative CT scan showing no infarction in PCA territory or midbrain. Symptoms from posterior cerebral artery (PCA) stenosis are uncommon and are usually secondary to ischemia of the distal territory of the vessel and include visual and sensory disturbances. One patient (Case 7) with a left P2 dissecting aneurysm suffered right-limb numbness due to a thalamus infarction after occlusion of the aneurysm and the parent artery.

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