Endovascular Treatment of Atypical Posterior Circulation Aneurysms: Technical Results and Review of the Literature
Brian T. Jankowitz MD
From the Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh PA (AA, RL, TJ); Department of Neurosurgery, Beth Israel Deaconess Medical Center, Boston, MA (AJT); Neuroscience Institute, Cleveland Clinic, Cleveland, OH (RG); Department of Neurology, Saint Louis University, Saint Louis, MS (NV); Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA (BTJ, DK, KSR, NP, MH).
Search for more papers by this authorAitziber Aleu MD
From the Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh PA (AA, RL, TJ); Department of Neurosurgery, Beth Israel Deaconess Medical Center, Boston, MA (AJT); Neuroscience Institute, Cleveland Clinic, Cleveland, OH (RG); Department of Neurology, Saint Louis University, Saint Louis, MS (NV); Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA (BTJ, DK, KSR, NP, MH).
Search for more papers by this authorRidwan Lin MD
From the Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh PA (AA, RL, TJ); Department of Neurosurgery, Beth Israel Deaconess Medical Center, Boston, MA (AJT); Neuroscience Institute, Cleveland Clinic, Cleveland, OH (RG); Department of Neurology, Saint Louis University, Saint Louis, MS (NV); Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA (BTJ, DK, KSR, NP, MH).
Search for more papers by this authorDean Kostov MD
From the Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh PA (AA, RL, TJ); Department of Neurosurgery, Beth Israel Deaconess Medical Center, Boston, MA (AJT); Neuroscience Institute, Cleveland Clinic, Cleveland, OH (RG); Department of Neurology, Saint Louis University, Saint Louis, MS (NV); Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA (BTJ, DK, KSR, NP, MH).
Search for more papers by this authorAjith J. Thomas MD
From the Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh PA (AA, RL, TJ); Department of Neurosurgery, Beth Israel Deaconess Medical Center, Boston, MA (AJT); Neuroscience Institute, Cleveland Clinic, Cleveland, OH (RG); Department of Neurology, Saint Louis University, Saint Louis, MS (NV); Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA (BTJ, DK, KSR, NP, MH).
Search for more papers by this authorRishi Gupta MD
From the Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh PA (AA, RL, TJ); Department of Neurosurgery, Beth Israel Deaconess Medical Center, Boston, MA (AJT); Neuroscience Institute, Cleveland Clinic, Cleveland, OH (RG); Department of Neurology, Saint Louis University, Saint Louis, MS (NV); Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA (BTJ, DK, KSR, NP, MH).
Search for more papers by this authorNirav Vora MD
From the Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh PA (AA, RL, TJ); Department of Neurosurgery, Beth Israel Deaconess Medical Center, Boston, MA (AJT); Neuroscience Institute, Cleveland Clinic, Cleveland, OH (RG); Department of Neurology, Saint Louis University, Saint Louis, MS (NV); Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA (BTJ, DK, KSR, NP, MH).
Search for more papers by this authorKim Seong R MD
From the Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh PA (AA, RL, TJ); Department of Neurosurgery, Beth Israel Deaconess Medical Center, Boston, MA (AJT); Neuroscience Institute, Cleveland Clinic, Cleveland, OH (RG); Department of Neurology, Saint Louis University, Saint Louis, MS (NV); Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA (BTJ, DK, KSR, NP, MH).
Search for more papers by this authorNarendra Panapitiya BS
From the Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh PA (AA, RL, TJ); Department of Neurosurgery, Beth Israel Deaconess Medical Center, Boston, MA (AJT); Neuroscience Institute, Cleveland Clinic, Cleveland, OH (RG); Department of Neurology, Saint Louis University, Saint Louis, MS (NV); Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA (BTJ, DK, KSR, NP, MH).
Search for more papers by this authorTudor Jovin MD
From the Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh PA (AA, RL, TJ); Department of Neurosurgery, Beth Israel Deaconess Medical Center, Boston, MA (AJT); Neuroscience Institute, Cleveland Clinic, Cleveland, OH (RG); Department of Neurology, Saint Louis University, Saint Louis, MS (NV); Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA (BTJ, DK, KSR, NP, MH).
Search for more papers by this authorMichael Horowitz MD
From the Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh PA (AA, RL, TJ); Department of Neurosurgery, Beth Israel Deaconess Medical Center, Boston, MA (AJT); Neuroscience Institute, Cleveland Clinic, Cleveland, OH (RG); Department of Neurology, Saint Louis University, Saint Louis, MS (NV); Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA (BTJ, DK, KSR, NP, MH).
Search for more papers by this authorBrian T. Jankowitz MD
From the Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh PA (AA, RL, TJ); Department of Neurosurgery, Beth Israel Deaconess Medical Center, Boston, MA (AJT); Neuroscience Institute, Cleveland Clinic, Cleveland, OH (RG); Department of Neurology, Saint Louis University, Saint Louis, MS (NV); Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA (BTJ, DK, KSR, NP, MH).
Search for more papers by this authorAitziber Aleu MD
From the Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh PA (AA, RL, TJ); Department of Neurosurgery, Beth Israel Deaconess Medical Center, Boston, MA (AJT); Neuroscience Institute, Cleveland Clinic, Cleveland, OH (RG); Department of Neurology, Saint Louis University, Saint Louis, MS (NV); Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA (BTJ, DK, KSR, NP, MH).
Search for more papers by this authorRidwan Lin MD
From the Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh PA (AA, RL, TJ); Department of Neurosurgery, Beth Israel Deaconess Medical Center, Boston, MA (AJT); Neuroscience Institute, Cleveland Clinic, Cleveland, OH (RG); Department of Neurology, Saint Louis University, Saint Louis, MS (NV); Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA (BTJ, DK, KSR, NP, MH).
Search for more papers by this authorDean Kostov MD
From the Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh PA (AA, RL, TJ); Department of Neurosurgery, Beth Israel Deaconess Medical Center, Boston, MA (AJT); Neuroscience Institute, Cleveland Clinic, Cleveland, OH (RG); Department of Neurology, Saint Louis University, Saint Louis, MS (NV); Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA (BTJ, DK, KSR, NP, MH).
Search for more papers by this authorAjith J. Thomas MD
From the Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh PA (AA, RL, TJ); Department of Neurosurgery, Beth Israel Deaconess Medical Center, Boston, MA (AJT); Neuroscience Institute, Cleveland Clinic, Cleveland, OH (RG); Department of Neurology, Saint Louis University, Saint Louis, MS (NV); Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA (BTJ, DK, KSR, NP, MH).
Search for more papers by this authorRishi Gupta MD
From the Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh PA (AA, RL, TJ); Department of Neurosurgery, Beth Israel Deaconess Medical Center, Boston, MA (AJT); Neuroscience Institute, Cleveland Clinic, Cleveland, OH (RG); Department of Neurology, Saint Louis University, Saint Louis, MS (NV); Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA (BTJ, DK, KSR, NP, MH).
Search for more papers by this authorNirav Vora MD
From the Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh PA (AA, RL, TJ); Department of Neurosurgery, Beth Israel Deaconess Medical Center, Boston, MA (AJT); Neuroscience Institute, Cleveland Clinic, Cleveland, OH (RG); Department of Neurology, Saint Louis University, Saint Louis, MS (NV); Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA (BTJ, DK, KSR, NP, MH).
Search for more papers by this authorKim Seong R MD
From the Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh PA (AA, RL, TJ); Department of Neurosurgery, Beth Israel Deaconess Medical Center, Boston, MA (AJT); Neuroscience Institute, Cleveland Clinic, Cleveland, OH (RG); Department of Neurology, Saint Louis University, Saint Louis, MS (NV); Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA (BTJ, DK, KSR, NP, MH).
Search for more papers by this authorNarendra Panapitiya BS
From the Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh PA (AA, RL, TJ); Department of Neurosurgery, Beth Israel Deaconess Medical Center, Boston, MA (AJT); Neuroscience Institute, Cleveland Clinic, Cleveland, OH (RG); Department of Neurology, Saint Louis University, Saint Louis, MS (NV); Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA (BTJ, DK, KSR, NP, MH).
Search for more papers by this authorTudor Jovin MD
From the Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh PA (AA, RL, TJ); Department of Neurosurgery, Beth Israel Deaconess Medical Center, Boston, MA (AJT); Neuroscience Institute, Cleveland Clinic, Cleveland, OH (RG); Department of Neurology, Saint Louis University, Saint Louis, MS (NV); Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA (BTJ, DK, KSR, NP, MH).
Search for more papers by this authorMichael Horowitz MD
From the Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh PA (AA, RL, TJ); Department of Neurosurgery, Beth Israel Deaconess Medical Center, Boston, MA (AJT); Neuroscience Institute, Cleveland Clinic, Cleveland, OH (RG); Department of Neurology, Saint Louis University, Saint Louis, MS (NV); Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA (BTJ, DK, KSR, NP, MH).
Search for more papers by this authorFunding Sources: Michael Horowitz received an unrestricted educational grant from ev3. We have no other commercial or financial associations to disclose.
J Neuroimaging 2011;21:56-61.
Abstract
ABSTRACT
BACKGROUND
We report our technical success and complication rates in treating posterior circulation aneurysms at sites other than the basilar apex, superior cerebellar artery origin, or the posterior inferior cerebellar artery origin via endovascular embolization or sacrifice.
MATERIALS AND METHODS
We retrospectively reviewed case records for patients undergoing coil embolization of atypical posterior circulation aneurysms from January 2003 to December 2007.
RESULTS
Thirty-two aneurysms in 32 patients were treated. Twenty-one patients (65%) presented with a subarachnoid hemorrhage. Twenty-two aneurysms were treated with coiling alone, 9 with stent-assisted coiling, and 1 with a combination of Onyx plus stent-assisted coiling. Twelve aneurysms were treated with vessel sacrifice. Immediately post procedure, 27/32 aneurysms (84%) were considered successfully treated, resulting in either vessel sacrifice, complete obliteration, or minimal neck remnant. Sixteen of 19 patients (84%) were considered successfully treated at a mean angiographic follow up of 8 months. The procedural morbidity and mortality was 15% and 6% respectively.
CONCLUSION
Endovascular embolization remains a viable and durable method of treatment for atypical posterior circulation aneurysms.
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