![]() Of these 256 patients, eight patients (7 female, 1 male mean age, 53 years age range, 26-65 years) had saccular PICA aneurysms and were the target of this research. Over the last seven years (1999-2006), we treated 256 patients with 271 cerebral aneurysms, by endovascular methods. We obtained institutional review board approval for the retrospective analysis of this study. The opportunity arose to treat eight patients with saccular PICA aneurysms by endovascular techniques, and our results were as follows. The use of endovascular treatment as an alternative treatment has been increasing since it avoids the manipulation of important posterior fossa structures ( 5, 6, 9 - 13). Surgery is difficult because of the intimate relationship of the proximal PICA to the medulla and the lower cranial nerves ( 7, 8). The management of PICA aneurysms is challenging, in particular for the VA-PICA junction and the proximal segment aneurysms. ![]() Aneurysms may arise from all segments of the PICA, with the majority originating from the vertebral artery (VA)-PICA junction and the proximal segments. The PICA has the most complex and variable course of the cerebellar arteries, and previous studies have differentiated the segments of the PICA based on its relationships to the medulla oblongata and cerebellum ( 3 - 6). Posterior inferior cerebellar artery (PICA) aneurysms are rarely encountered, ranging in incidence between 0.5 and 3.0% of all occurring intracranial aneurysms ( 1 - 3).
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