Artikel
Flow diverter devices as treatment option for complex (fusiform) superior cerebellar artery (SCA) aneurysms – review of literature and illustrative case
Flow Diverter-Devices als Behandlungsoption für komplexe (fusiforme) Aneurysmen der Ateria cerebelli superior (SCA) – Literaturübersicht und illustrativer Fall
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Veröffentlicht: | 4. Juni 2021 |
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Objective: Superior cerebellar artery (SCA) aneurysms are rare entity accounting for only 0.2% of all cerebral aneurysms, with only a small portion of these being fusiform aneurysms. Due to this rarity, there are few studies and reports that compare the different therapy options. Currently, surgical revascularization procedures using IC-IC or EC-IC bypass and distal clipping or trapping are the valid and rescue treatment modality for extremely rare unilateral distal fusiform superior cerebellar artery (SCA) aneurysms. Jet, in case of bilateral fusiform SCA aneurysms surgical therapy reaches its limit. Mini-FDDs have only recently become available for treating fusiform aneurysms of such small vessels. However, clinical experience with these devices is still lacking. Therefore, as part of treatment in the complex case of bilateral SCA aneurysms in our clinic, we examined the data on the use of flow diverters in SCA aneurysms.
Methods: We present an illustrative case of bilateral distal fusiform SCA aneurysms treated with endovascular implantation of two mini-FDDs. Furthermore, we performed a review of the literature using the electronic databases PubMed and Google Scholar to search for additional data in published studies and case reports of SCA aneurysms treated with FDDs.
Results: Overall, 7 studies and case reports presenting 8 patients in whom an SCA aneurysm was treated with endovascular FDD implantation, were found. In particular, complex aneurysms without any further treatment option were treated with FDDs jet, only 2 patients had fusiform aneurysms. Nevertheless, 78% of the patients showed no or little impairment (mRS = 0-2) on discharge. Except for the dislocation of the FDD in one case, only complications related to post-procedural dual platelet therapy occurred.
Conclusion: Endovascular therapy with implantation of FDDs in selected cases of distal SCA aneurysms is a valid treatment option. As in the present patient, reported cases in the literature demonstrated an overall good clinical outcome.