Introduction: Fusiform aneurysms arising from segments of the anterior, middle, and posterior cerebral arteries are uncommon entities. These aneurysms can be managed microsurgically or via endovascular means. Due to the inherent geometry of many fusiform aneurysms, treatment may be difficult to achieve without sacrificing the parent vessel. This observational study aims to describe our experience with parent artery occlusion for the management of fusiform aneurysms.
Methods: A retrospective chart review of cases from our institutional aneurysm database was performed. Of this collection, 14 cases were identified as having fusiform geometry aneurysm with management via parent artery occlusion. We reviewed the clinical presentation, imaging, treatment method, clinical progression, and imaging follow up.
Results: Of the 14 patients with fusiform aneurysms, involved arteries included the middle cerebral artery (2), the anterior cerebral artery (3), the posterior cerebral artery (7), the anterior inferior cerebellar artery (1), and the posterior inferior cerebellar artery (1). All cases were managed via parent artery occlusion, of which 6 were treated microsurgically and 8 were treated via endovascular means. Post-procedural imaging demonstrated stroke in 9 patients. At 6 month post-procedural follow up, 10 patients were without neurological deficit.
Conclusions: From our observational study, it appears that parent artery occlusion of fusiform aneurysms via endovascular or microsurgical means is a viable treatment method with relatively few neurologic deficits post-treatment. Although in most cases parent artery occlusion results in radiographic stroke, patients clinically do quite well with limited long term sequela.
Patient Care: parent artery occlusion may be a safe treatment with low frequency of consequences for management of fusiform aneurysms.
Learning Objectives: By the conclusion of this session, participants should be able to identify parent artery occlusion as an effective alternative for management of fusiform aneurysms