caa a22 4500 606215298 CHVBK 20210128101058.0 cr unu---uuuuu 210128e20151001xx s 000 0 eng 10.1007/s00701-015-2526-1 doi (NATIONALLICENCE)springer-10.1007/s00701-015-2526-1 Treatment strategies for dissecting aneurysms of the posterior cerebral artery [Elektronische Daten] [Wonhyoung Park, Do Kwon, Jae Ahn, Sung Lee, Jung Park, Byung Kwun] Background: Dissecting aneurysms of the posterior cerebral artery (PCA) are rare and difficult to treat because of their deep and unfamiliar locations and unusual shapes. Although several treatment modalities have been proposed, none have generated satisfying results. Our experiences with PCA-dissecting aneurysms are reviewed and the treatment strategies discussed. Methods: All consecutive patients with PCA-dissecting aneurysm who were treated in a tertiary referral hospital between January 1998 and March 2014 were identified by retrospective review. Their clinical characteristics, radiological findings, treatment modalities and outcomes were documented. Results: Of the 21 patients with 21 PCA-dissecting aneurysms, 9 had subarachnoid hemorrhage and 3 had acute infarction of the thalamus at presentation. The aneurysms involved P1 (n = 4), the P1-2 junction (n = 3), mid-P2 (n = 6), P2A (n = 3), P2P (n = 1) and the P2-3 junction (n = 4). The aneurysm shapes were as follows: fusiform (n = 12), partially thrombosed (n = 8) and blood blister-like aneurysms (n = 1). The mean size was 16.6 ± 9.7mm. Parent artery occlusion (PAO) without bypass (n = 15), PAO with bypass (n = 2), stent-assisted endosaccular coiling (n = 3) and stent placement only (n = 1) were performed. All three patients who underwent stent-assisted endosaccular coiling and the single patient who underwent PAO without bypass developed aneurysm recurrence. Six of the ten patients who received a PAO without a balloon test occlusion (BTO) experienced PCA territory infarction, whereas only one of the five patients who received a PAO after passing the BTO experienced an infarction. Conclusions: PAO for PCA-dissecting aneurysm was effective in preventing recurrence. In addition, BTO before PAO was helpful in identifying candidates who truly needed surgical revascularization. Springer-Verlag Wien, 2015 Cerebral revascularization nationallicence Dissection nationallicence Endovascular procedures nationallicence Intracranial aneurysms nationallicence Posterior cerebral artery nationallicence Therapeutic occlusion nationallicence Park Wonhyoung Department of Neurosurgery, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, 138-736, Songpa-gu, Seoul, Korea aut Kwon Do Department of Neurosurgery, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, 138-736, Songpa-gu, Seoul, Korea aut Ahn Jae Department of Neurosurgery, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, 138-736, Songpa-gu, Seoul, Korea aut Lee Sung Department of Neurosurgery, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, 138-736, Songpa-gu, Seoul, Korea aut Park Jung Department of Neurosurgery, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, 138-736, Songpa-gu, Seoul, Korea aut Kwun Byung Department of Neurosurgery, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, 138-736, Songpa-gu, Seoul, Korea aut Acta Neurochirurgica Springer Vienna 157/10(2015-10-01), 1633-1643 0001-6268 157:10<1633 2015 157 701 https://doi.org/10.1007/s00701-015-2526-1 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00701-015-2526-1 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Park Wonhyoung Department of Neurosurgery, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, 138-736, Songpa-gu, Seoul, Korea aut NATIONALLICENCE 700 1- Kwon Do Department of Neurosurgery, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, 138-736, Songpa-gu, Seoul, Korea aut NATIONALLICENCE 700 1- Ahn Jae Department of Neurosurgery, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, 138-736, Songpa-gu, Seoul, Korea aut NATIONALLICENCE 700 1- Lee Sung Department of Neurosurgery, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, 138-736, Songpa-gu, Seoul, Korea aut NATIONALLICENCE 700 1- Park Jung Department of Neurosurgery, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, 138-736, Songpa-gu, Seoul, Korea aut NATIONALLICENCE 700 1- Kwun Byung Department of Neurosurgery, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, 138-736, Songpa-gu, Seoul, Korea aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer Vienna 157/10(2015-10-01), 1633-1643 0001-6268 157:10<1633 2015 157 701