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- W620711345 abstract "Vertebral artery (VA) dissecting aneurysms that involve the origin of the posterior inferior cerebellar artery (PICA-involved type) have a hemodynamically unique character. To our knowledge, discussions of the ideal surgical treatment have not involved enough patients.We conducted a retrospective clinical study of 14 patients with PICA-involved vertebral artery (VA) dissecting aneurysm presenting subarachnoid hemorrhage. The 14 patients underwent 15 surgical procedures, including 6 proximal clippings alone, 2 aneurysm body clippings just distal to the origin of PICA, 1 proximal clipping combined with PICA clipping, and 6 trappings.Of the 7 patients treated with methods sacrificing PICA (trapping, proximal clipping combined with PICA clipping), 4 (57.7%) developed infarction in the distribution of PICA. Of the 8 patients treated with methods sparing PICA (proximal clipping, aneurysm body clipping), 2 (25%) developed infarction. Aneurysm persisted in 4 of the 6 patients treated with proximal clipping alone. In one of the 4 patients, rebleeding occurred on the 18th postoperative day.Proximal clipping alone may be unfavorable for the treatment of PICA-involved VA dissecting aneurysms, because thrombosis of the aneurysm is delayed due to a retrograde flow from the contralateral VA into ipsilateral PICA, carrying a risk of rebleeding. Proximal clipping with additional PICA clipping or trapping with revascularization of PICA are recommended." @default.
- W620711345 created "2016-06-24" @default.
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- W620711345 date "1999-01-01" @default.
- W620711345 modified "2023-10-05" @default.
- W620711345 title "Surgical Considerations for PICA-involved Type Vertebral Dissecting Aneurysm" @default.
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- W620711345 doi "https://doi.org/10.2335/scs1987.27.5_369" @default.
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