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Endovascular treatment for superior cerebellar artery aneurysms: morphological features, technique, and outcome

  • Interventional Neuroradiology
  • Published:
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Abstract

Introduction

Superior cerebellar artery (SCA) aneurysms have distinctive morphologic configurations and vascular origins. Herein, we have analyzed the angioarchitectural characteristics of SCA aneurysms and outcomes achieved through endovascular treatment.

Methods

Data accruing prospectively from January, 2002 to September, 2013 yielded 53 SCA aneurysms in 53 patients. Each lesion was classified as either basilar artery (BA), BA–SCA, or SCA type, according to the nature of incorporated vasculature. Clinical and morphologic outcomes were assessed, with emphasis on technical aspects of treatment.

Results

Angles formed by SCA and posterior cerebral artery were obtuse (124.8 ± 29.1°) on sides ipsilateral to aneurysms, differing significantly from contralateral counterparts (44.8 ± 22.0°) (p < 0.001). The most common type of aneurysm was BA-SCA (54.7 %), followed by SCA (28.3 %) and BA (17.0 %), and BA type aneurysms were the largest in size. Steam-shaped S-configured microcatheters (n = 19, 67.9 %) facilitated aneurysm selection for approach via contralateral vertebral artery (n = 28), whereas pre-shaped 45/90/J microcatheters (n = 21, 84.0 %) primarily were used for ipsilateral vertebral artery approach (n = 25). Single-microcatheter technique (52.8 %) was most often applied, followed by double-microcatheter (34.0 %), stent-assisted (9.4 %), and microcatheter-protection techniques (3.8 %). Aneurysmal occlusion was satisfactorily achieved in 45 lesions (82.1 %), with no procedure-related morbidity and mortality. In follow-up monitoring of 46 patients for a mean period of 25.8 ± 24.4 months, only a single instance of major recanalization (2.2 %) occurred.

Conclusion

Coil embolization of SCA aneurysms is a safe and effective treatment modality, enabling individualized procedural strategies to accommodate distinctive angio-anatomic configurations.

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Ethical Standards and Patient Consent

We declare that all human and animal studies have been approved by the Institutional Review Board of Seoul National University Hospital and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients gave informed consent prior to inclusion in this study.

Acknowledgments

This study was supported by a grant of the Korea Healthcare Technology R&D Project, Ministry for Health, Welfare & Family Affairs, Republic of Korea (A111101).

Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Neurology, Stroke Center, Myongji Hospital, Goyang, South Korea

    Chang Hun Kim

  2. Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, 28 Yongon-dong, Jongno-gu, Seoul, 110-744, South Korea

    Young Dae Cho, Seung Chai Jung, Jun Hyong Ahn & Moon Hee Han

  3. Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea

    Hyun-Seung Kang, Jeong Eun Kim, Won-Sang Cho & Moon Hee Han

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  1. Chang Hun Kim
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  2. Young Dae Cho
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  3. Seung Chai Jung
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  6. Jeong Eun Kim
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  7. Won-Sang Cho
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Correspondence to Young Dae Cho.

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Kim, C.H., Cho, Y.D., Jung, S.C. et al. Endovascular treatment for superior cerebellar artery aneurysms: morphological features, technique, and outcome. Neuroradiology 56, 647–654 (2014). https://doi.org/10.1007/s00234-014-1375-6

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  • DOI: https://doi.org/10.1007/s00234-014-1375-6

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