![]() ![]() Although NBCA is most commonly known as an endovascular treatment option for cerebral arteriovenous malformation, neurointerventionalist have begun to utilize cyanoacrylate glues for several vascular brain pathologies. N-butyl cyanoacrylate (NBCA) is commonly used liquid embolic agent in the endovascular treatment of cerebrovascular and peripheral vascular pathologies. ĭolichoectatic arteries and fusiform aneurysms are related to arteriopathies and connective tissue diseases, andjust 2% of the intracranial aneurysms are located in the vertebral-posterior inferior cerebellar arteries (PICAs). These lesions are commonly mistaken for aneurysms or arteriovenous malformations. The pure arterial malformation (PAM) lesion has been recently described as a vascular pathology characterized by the sole presence of coiled, sometimes ectaticor arterial loops. The injection of the mixture of NBCA and Lipiodol® under roadmap fluoroscopy is very safe.įusiform aneurysm, Pure arterial malformation, N-butyl cyanoacrylate, Roadmap fluoroscopy Is important to make the best decision to treat them because the potential complications that's why the procedure were supported with super-selective Wada test and neuromonitoring of the PICA territory. ![]() With a negative super-selective Wada test the patient was treated with embolization of the two lesions and the PICA for being in the same arterial territory with adhesive embolic liquid under roadmap fluoroscopy technique.Ĭonclusion: These two vascular lesions located in the same artery are very rare and more in the PICA territory. The pure arterial malformation (PAM) lesion has been recently described as a vascular pathology characterized by the sole presence of coiled, sometimes ecstatic, arterial loops.Ģ% of the fusiform aneurysms are located in the vertebral-posterior inferior cerebellar arteries.Ī 60 years old female with subarachnoid hemorrhage was diagnosed with a fusiform aneurysm in the right PICA related with a PAM in the digital subtraction angiography (DSA). © 2016 by American Journal of Neuroradiology.Posteroinferior Cerebellar Artery (PICA) Fusiform Aneurysm Ruptured Related with a Pure Arterial Malformation: Case Report and Technical Note (NBCA Embolization under Roadmap-Fluoroscopy) In 11 patients with follow-up angiography at a mean of 10.6 months (range, 0.67-27.9 months), the PICA patency rate remained 100%.įlow-diverting stent placement across the PICA ostium in the treatment of vertebral and vertebrobasilar artery aneurysms may not result in immediate or midterm PICA occlusion. There were no postoperative strokes in the treated PICA territory, although there was 1 contralateral PICA-territory stroke of unclear etiology without clinical sequelae. The average number of devices that spanned the PICA ostium was 1.77 (range, 1-3), with no immediate PICA occlusions. Thirteen patients with vertebral or vertebrobasilar artery aneurysms were treated in the study period, of whom 4 presented with subarachnoid hemorrhage. Patency of the PICA was evaluated immediately after stent placement and on follow-up angiography. Demographic and procedural factors associated with stent placement were recorded. Patients were identified who had vertebral or vertebrobasilar artery aneurysms and who were treated by placing a flow-diverting stent across the PICA ostium. The purpose of this study is to determine the medium-term rate of PICA patency and risk factors for occlusion after such aneurysm treatment. The rate of PICA occlusion after flow-diverting stent placement for vertebral and vertebrobasilar artery aneurysms is not known. ![]()
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