Flow Diversion for Treatment of Anterior Inferior Cerebellar Artery Aneurysms: Mechanism and Pitfalls from a Novel Management Strategy

Sanjeev Sreenivasan; Sudipta Roychowdhury; Ananth Kashibathla; Siddhant Kumarapuram; Emad Nourollah-Zadeh; Srihari Sundararajan; Hai Sun; Anil Nanda; Gaurav Gupta

doi:10.1016/j.wneu.2023.11.064

Flow Diversion for Treatment of Anterior Inferior Cerebellar Artery Aneurysms: Mechanism and Pitfalls from a Novel Management Strategy

World Neurosurg. 2024 Feb:182:e163-e170. doi: 10.1016/j.wneu.2023.11.064. Epub 2023 Nov 20.

Authors

Sanjeev Sreenivasan¹, Sudipta Roychowdhury², Ananth Kashibathla¹, Siddhant Kumarapuram¹, Emad Nourollah-Zadeh³, Srihari Sundararajan², Hai Sun¹, Anil Nanda¹, Gaurav Gupta⁴

Affiliations

¹ Department of Neurosurgery, Robert Wood Johnson Medical School, Rutgers University, New Jersey, USA.
² Department of Interventional Radiology, University Radiology, Robert Wood Johnson Medical School, New Jersey, USA.
³ Department of Neurology, Robert Wood Johnson Medical School, Rutgers University, New Jersey, USA.
⁴ Department of Neurosurgery, Robert Wood Johnson Medical School, Rutgers University, New Jersey, USA. Electronic address: guptaga@rwjms.rutgers.edu.

PMID: 37992994
DOI: 10.1016/j.wneu.2023.11.064

Abstract

Background: Anterior inferior cerebellar artery (AICA) aneurysms present a challenge for neurosurgeons and neurointerventionalists alike.

Methods: Cases of AICA aneurysms managed with endovascular flow diversion at our institute are reviewed with their angiographic outcomes.

Results: Both direct and indirect flow diversion provide complete aneurysm occlusion at follow-up. We propose a stratified method of approaching AICA aneurysms based on location, rupture status, and neck size.

Conclusions: Careful evaluation of preoperative parameters is paramount in deciding between a surgical or a neuroendovascular approach. Low-profile stents in the future may assist in direct flow diversion of AICA trunk aneurysms. In addition, neurosurgeons need to be well versed in endovascular approaches.

Keywords: Anterior inferior cerebellar artery; Endovascular; Flow diversion; Strategy; Surgery.

MeSH terms

Arteries
Cerebellum / blood supply
Cerebellum / diagnostic imaging
Cerebellum / surgery
Embolization, Therapeutic* / methods
Endovascular Procedures* / methods
Humans
Intracranial Aneurysm* / diagnostic imaging
Intracranial Aneurysm* / surgery
Retrospective Studies
Stents
Treatment Outcome