Treatment experience of posterior inferior cerebellar artery aneurysms

Objective To summarize the experience of treating posterior inferior cerebellar artery (PICA) aneurysms. Methods A total of 80 cases of PICA aneurysms were respectively treated by interventional embolization (49 cases), clipping (19 cases) and anastomosis of occipital artery (OA) and PICA combined with embolization (12 cases). The indications and technical features of three kinds of surgeries were summarized. Results Interventional embolization was applied to 49 cases, with a success rate of 95.92% (47/49). Clipping was applied to 19 cases, with a success rate of 16/19. Anastomosis of OA and PICA combined with embolization was applied to other 12 cases, with a success rate of 11/12. In all of 80 cases, 2 cases were ended up to death after surgery, 21 cases were found neurological deficiency, such as dysphagia, hoarseness and limb dyskinesia, and other 57 cases were greatly improved. The mean follow-up period was 3.65 years, and 7 cases were found recurrent aneurysms in the reexamination of computed tomography angiography (CTA) or digital subtraction angiography (DSA).  Conclusions Interventional embolization has relatively small incision and short operation time, while clipping is safe and feasible for patients with tortuous posterior circulation blood vessels, small aneurysms and wide aneurysm neck. For patients who have difficulty in undergoing embolization and clipping, anastomosis of arteries combined with embolization is the final choice. DOI: 10.3969/j.issn.1672-6731.2016.07.012