Endovascular treatment of dissecting aneurysms of the posterior cerebral artery.

Abstract

In the literature, there are few reports of posterior cerebral artery aneurysms resulting from isolated dissections. In these cases the treatment is still a matter of discussion and includes anticoagulation, surgical intervention, endovascular techniques and conservative management. We present five cases of Posterior Cerebral Artery (PCA) aneurysms, with angiographic criteria of dissection (double lumen, proximal narrowing), all being situated at the P2 segment, three being close to the P1/P2 junction. In one case, a large aneurysm ruptured during the attempted catheterization with subsequent death of the patient. In three patients occlusion of the parent vessel was performed with Guglielmi detachable coils located proximal to the aneurysm, with no new neurological deficits. In the other case there was spontaneous thrombosis of the aneurysm. Occlusion of the parent vessel by endovascular techniques in dissecting PCA aneurysms has a low probability of neurological deficits and seems to be an appropriate approach for these aneurysms.