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Pica artery full form7/30/2023 Sixty aneurysms in 58 patients were located on the PICA. 9– 12 In this study, we report our experience with endovascular treatment of 47 proximal PICA aneurysms in 46 patients.īetween January 1995 and March 2007, 2169 aneurysms were treated in our institution, 940 surgically and 1229 endovascularly. 1– 8 Although endovascular treatment of intracranial aneurysms is increasingly used as an alternative to surgery, endovascular results of PICA aneurysms are not well established. Surgery for these aneurysms is challenging due to the deep location and intimate relation with the medulla and cranial nerves IX, X, and XI. Although this was effective in alleviation of symptoms of mass effect, it was not effective in causing thrombosis of the aneurysm.Īneurysms of the posterior inferior cerebellar artery (PICA) are rare. In other instances, treatment required occlusion of the VA. In some instances, endovascular treatment required occlusion of the parent PICA usually this was well tolerated. Symptoms of mass effect resolved in all 4 patients.ĬONCLUSION: In our experience, PICA aneurysms were challenging lesions, prone to procedural rupture. No hemorrhage occurred during 109 patient-years of follow-up. Outcome at 6 months in 38 surviving patients was good in 35 and moderate in 3. Combined mortality and morbidity was 8.6% (4 of 46). One patient developed lateral medullary and cerebellar infarctions after PICA occlusion. Procedural rupture occurred in 9 aneurysms leading to death in 2 patients and to permanent disability in 1 patient. RESULTS: Four aneurysms treated with proximal VA occlusion were not occluded. Forty-three aneurysms were occluded with coils (6 including the PICA origin), and 4 were treated with proximal vertebral artery (VA) occlusion. Mean aneurysm size was 6.8 mm (median, 6 mm range, 2–32 mm). Four patients presented with lower cranial nerve palsies. Forty-seven proximal PICA aneurysms in 46 patients were treated with endovascular techniques, 37 ruptured (79%) and 10 unruptured (21%). MATERIALS AND METHODS: Of 2169 aneurysms treated between January 1995 and March 2007, 60 were located on the PICA (incidence, 2.8%). The purpose of this study was to report incidence, clinical presentation, and outcome of endovascular treatment in 46 patients with 47 posterior inferior cerebellar artery (PICA) aneurysms. It has a variable territory depending on the size of the AICA ( AICA-PICA dominance).BACKGROUND AND PURPOSE: Results of endovascular treatment of PICA aneurysms are not well established. ![]() Note: occasionally, a small vertebral artery will terminate into a common AICA-PICA complex. The posterior inferior cerebellar artery gives off the following arteries: Supplies the vermis and adjacent hemisphere ![]() The main trunk of the posterior inferior cerebellar artery usually bifurcates somewhere along the margin of the cerebellar tonsil into Supplies branches to the cerebellar surface Marks the transition between the proximal (medulla-supplying) and distal (cerebellum-supplying) parts of the posterior inferior cerebellar arteryĬourses in the cleft between the tela choroidea, inferior medullary velum rostrally, and superior pole of the cerebellar tonsil caudallyĬontains the cranial loop, also known as the choroid point or choroid arch, an upward convex loop that has a constant relation to the 4 th ventricle and gives rise to choroidal arteries Variably courses (ascending or descending) along the side of the medulla near or between the origins of the 9 th, 10 th, and 11 th cranial nerve rootsĬourses along the posterolateral surface of the medulla and inferior cerebellar tonsilĬontains the caudal loop, a downward convex loop that mostly remain superior to the foramen magnum but occasionally extend below it 6,7:Ĭourses along the front of the medulla at the level of the inferior olive The segmental anatomy was defined microsurgically by Lister et al. Occasionally arises from a common origin with the anterior inferior cerebellar artery ~20% arise extracranially, inferior to the foramen magnumġ0% arise from the basilar rather than vertebral artery The PICA is a paired artery that originates from the vertebral artery V4 segment.
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