Universität zu Köln

Goertz, L., Liebig, T., Siebert, E., Ozpeynirci, Y., Pennig, L., Celik, E., Schlamann, M., Dorn, F. and Kabbasch, C. (2022). Treatment of Proximal Posterior Inferior Cerebellar Artery Aneurysms by Intrasaccular Flow Disruption: A Multicenter Experience. Am. J. Neuroradiol., 43 (8). S. 1158 - 1164. DENVILLE: AMER SOC NEURORADIOLOGY. ISSN 1936-959X

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Abstract

BACKGROUND AND PURPOSE: Treatment of PICA aneurysms can be technically challenging by either surgical or endovascular means. Our aim was to report our preliminary experience with intrasaccular flow disruption using the Woven EndoBridge (WEB) for the treatment of proximal PICA aneurysms. MATERIALS AND METHODS: Sixteen PICA aneurysms treated with the WEB at 3 institutions were retrospectively reviewed. Baseline patient and aneurysm characteristics, procedural specifics, clinical outcomes, and angiographic results were evaluated. RESULTS: All aneurysms were located at the proximal, anteromedullary segment of the PICA. Seven aneurysms were ruptured. The median aneurysm size was 3.9?mm (range, 2?12?mm), and all aneurysms were wide-neck. WEB deployment failed in 1 case due to WEB protrusion in a small PICA aneurysm. Additional stent implantation was required for 2 aneurysms to improve intra-aneurysmal WEB positioning. One patient developed a partial posterior cerebral artery territory infarction with transient hemianopsia. Intraoperative rerupture of a ruptured aneurysm could be immediately stopped by WEB deployment due to intrasaccular stasis; however, it might have contributed to a slight disability of the patient. At last angiographic follow-up, 12/15 aneurysms (80%) were completely occluded and 3/15 (20%) had a neck remnant. CONCLUSIONS: The preliminary results indicate that WEB treatment of proximal PICA aneurysms is feasible with a reasonable safety and efficacy profile. The advantages of intrasaccular flow disruption include preservation of the PICA, durable aneurysm occlusion, and omission of antiplatelet therapy. The low-profile WEB 17 delivery system might enable navigation to distal PICA aneurysms, which needs to be addressed further.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Goertz, L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Liebig, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Siebert, E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ozpeynirci, Y. UNSPECIFIED UNSPECIFIED UNSPECIFIED Pennig, L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Celik, E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schlamann, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Dorn, F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kabbasch, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-679170
DOI:	10.3174/ajnr.A7566
Journal or Publication Title:	Am. J. Neuroradiol.
Volume:	43
Number:	8
Page Range:	S. 1158 - 1164
Date:	2022
Publisher:	AMER SOC NEURORADIOLOGY
Place of Publication:	DENVILLE
ISSN:	1936-959X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language WOVEN ENDOBRIDGE; ENDOVASCULAR TREATMENT; WEB Multiple languages Clinical Neurology; Neuroimaging; Radiology, Nuclear Medicine & Medical Imaging Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/67917