Endovascular treatment of posterior circulation aneurysms

The objective of this paper was to analyse the technical and clinical outco me in patients receiving endovascular treatment for posterior circulation i ntracranial aneurysms at Royal Perth Hospital. The case notes and angiogram s of 35 patients with ruptured and unruptured posterior circulation aneurys ms treated by endovascular coil occlusion between 1992 and 1998 were includ ed in the study. The degree of angiographic occlusion achieved, and peripro cedural, short and long-term clinical outcome were retrospectively analysed . Total aneurysm occlusion was achieved at initial treatment in 46% of case s, with 90% or greater occlusion achieved in 97% of cases. For aneurysms 12 mm or less in diameter, 100% of patients treated electively, and 100% of p atients with grade I or II subarachnoid haemorrhage treated in the acute po stictal phase had a good clinical outcome (Rankin Disability Score 1 and 2) , with no serious morbidity or associated mortality. Excluding patients wit h grade V subarachnoid haemorrhage, the treatment-related serious morbidity rate was 3.4% and procedure-related mortality rate was 0%. We conclude tha t endovascular management provides an effective means of treatment for sele cted cases of posterior circulation aneurysms.