Clinical Outcomes of Ruptured and Unruptured Vertebral Artery-Posterior Inferior Cerebellar Artery Complex Dissecting Aneurysms after

BACKGROUND AND PURPOSE: Surgical treatment of VA-PICA dissecting aneurysms is difficult and complication of LCNP is common. These lesions can be approached easily with endovascular tech-nique, but complete obliteration can only be achieved in a small number of cases. Our aim was to report the clinical outcomes of VA-PICA dissecting aneurysms treated by endovascular embolization. MATERIALS AND METHODS: Between 2001 and 2007, the authors treated 22 consecutive patients (15 men and 7 women; ranging in age from 12 to 59 years; mean age, 43 years) with VA-PICA dissecting aneurysms. Diagnosis of VA-PICA dissecting aneurysm was based on clinical, MR imaging, and cerebral angiography studies. RESULTS: Of the 22 patients, 6 had unruptured aneurysms. One patient presented with headaches, whereas the remaining 5 patients showed brain stem ischemia. Four were treated with stent-only or stent-coil embolization, and 2 were treated with unilateral VA occlusion. Among 16 patients presenting with SAH, 10 were treated with stent-only or stent-coil embolization. The other 6 patients with SAH were treated by using unilateral endovascular VA occlusion. One patient could not return to his previous daily activities. CONCLUSIONS: VA-PICA aneurysms are rare lesions associated with significant morbidity, and endo-vascular treatment strategies for these lesions were stent deployment with or without coil emboliza-tion and VA occlusion. Favorable clinical outcomes can be achieved with endovascular techniques. ABBREVIATIONS: BA basilar artery; CN VI sixth cranial nerve; Co complete; GOS Glasgow Outcome Scale; HH Hunt and Hess; In incomplete; LCNP lower cranial nerve palsy; SA