Therapeutic Occlusion of the Vertebral Artery for Unclippable Vertebral Aneurysm

Relationship between the site of occlusion and clinical outcome

Abstract

Six cases of unclippable vertebral aneurysms were treated by therapeutic occlusion of the proximal vertebral artery. Of these, three were clipped at the vertebral artery proximal to the posterior inferior cerebellar artery (PICA), and all of them had postoperative embolic complications or fatal subarachnoid hemorrhage. On the other hand, two patients in whom the vertebral artery was clipped distal to the PICA and one whose PICA was absent and vertebral artery was clipped proximal to the aneurysm did well without any neurologic deficits. Possible mechanisms of complications are discussed, and the importance of sparing the PICA from clipping is emphasized.