Original scientific paper

https://doi.org/10.20471/acc.2020.59.04.18

Endovascular Management of Intracranial Aneurysms on Distal Arterial Branches: Illustrative Case Series and Literature Retrospection

Krešimir Rotim ; Department of Neurosurgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; University of Applied Health Sciences, Zagreb, Croatia; Josip Juraj Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia
Bruno Splavski orcid.org/0000-0002-4483-9364 ; Department of Neurosurgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; University of Applied Health Sciences, Zagreb, Croatia; Josip Juraj Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia; Josip Juraj Strossmayer University of Osijek, Faculty of Dental Medicine and Health, Osijek, Croatia
Vladimir Kalousek ; Department of Radiology, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
Mia Jurilj ; Department of Neurosurgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; University of Applied Health Sciences, Zagreb, Croatia
Tomislav Sajko ; Department of Neurosurgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; University of Applied Health Sciences, Zagreb, Croatia

Abstract

Intracranial aneurysms located on distal arterial branches are sporadic and scarce.
They account for 2%-7% of the middle cerebral artery and 0.7%-2.3% of the posterior cerebral artery
aneurysms, where they mainly arise distally from the P2-related sites. Such aneurysms usually remain
asymptomatic prior to rupture, making their diagnosis and management really demanding. Endovascular
treatment comprising of different neurointerventional techniques is becoming the most operational
up-to-date routine to approach distal cerebral branch aneurysms. In this single-institution case
series, endovascular selective coiling and/or parent vessel occlusion resulted in successful and total
aneurysmal exclusion from cerebral circulation, which brought good recovery. Hereby, we present an
illustrative case series of distal arterial branch intracranial aneurysms, discussing their possible etiology
and various endovascular management modalities. We also provide a literature retrospection concerned
with this rare entity. In conclusion, due to their predisposition for rupture, distal branch intracranial
aneurysms should be treated early and aggressively. We do believe that endovascular selective
coil occlusion is the management method of choice, while parent vessel occlusion (with liquid embolics)
is optimal when aneurysmal coiling cannot be achieved, or when distal cortical territory is well
vascularized by strong collateral cerebral circulation.

Keywords

Cerebral arterial branches, distal; Aneurysm, intracranial; Endovascular treatment

Hrčak ID:

254885

URI

https://hrcak.srce.hr/254885

Publication date:

1.12.2020.

Article data in other languages: croatian

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