Endovascular Treatment of Atypical Posterior Circulation Aneurysms: Technical Results and Review of the Literature

ABSTRACT BACKGROUND We report our technical success and complication rates in treating posterior circulation aneurysms at sites other than the basilar apex, superior cerebellar artery origin, or the posterior inferior cerebellar artery origin via endovascular embolization or sacrifice. MATERIALS AND METHODS We retrospectively reviewed case records for patients undergoing coil embolization of atypical posterior circulation aneurysms from January 2003 to December 2007. RESULTS Thirty‐two aneurysms in 32 patients were treated. Twenty‐one patients (65%) presented with a subarachnoid hemorrhage. Twenty‐two aneurysms were treated with coiling alone, 9 with stent‐assisted coiling, and 1 with a combination of Onyx plus stent‐assisted coiling. Twelve aneurysms were treated with vessel sacrifice. Immediately post procedure, 27/32 aneurysms (84%) were considered successfully treated, resulting in either vessel sacrifice, complete obliteration, or minimal neck remnant. Sixteen of 19 patients (84%) were considered successfully treated at a mean angiographic follow up of 8 months. The procedural morbidity and mortality was 15% and 6% respectively. CONCLUSION Endovascular embolization remains a viable and durable method of treatment for atypical posterior circulation aneurysms.