Key result
Hybrid OA-AICA bypass with coiling achieves complete aneurysm occlusion while preserving neurological function.
Why the study?
Pediatric anterior inferior cerebellar artery aneurysms are rare, and radiation-associated dissecting lesions require exclusion without compromising brainstem or cerebellar perforators when direct clipping or isolated parent vessel occlusion is high risk.
Does a hybrid occipital artery-AICA a3 bypass followed by endovascular coil embolization achieve complete aneurysm occlusion while preserving distal perfusion and neurological function in a pediatric patient with a radiation-induced dissecting AICA aneurysm?
Case Report (n=1)
No
Does a hybrid occipital artery-AICA a3 bypass followed by endovascular coil embolization achieve complete aneurysm occlusion while preserving distal perfusion and neurological function in a pediatric patient with a radiation-induced dissecting AICA aneurysm?
Hybrid occipital artery-AICA bypass followed by same-session endovascular coil embolization is a feasible, flow-preserving treatment strategy for complex pediatric radiation-induced dissecting AICA aneurysms where direct clipping or isolated parent vessel occlusion is unsafe.
Answers are grounded in this paper and cite their sources.
Supports hybrid bypass-coil strategy in select pediatric radiation-induced AICA aneurysms; leaves open generalizability and safety in larger cohorts.
BACKGROUND AND IMPORTANCE: Pediatric anterior inferior cerebellar artery (AICA) aneurysms are rare; radiation-associated dissecting lesions require exclusion without compromising brainstem or cerebellar perforators. CLINICAL PRESENTATION: A 13-year-old boy developed a progressively enlarging right AICA a2 dissecting aneurysm after cranial irradiation for pineal nongerminomatous germ cell tumor. Because direct clipping or isolated parent vessel occlusion was considered high risk, he underwent occipital artery-AICA a3 bypass followed by endovascular coil embolization in a single hybrid session. Dual arterial access enabled transradial vertebral artery treatment and transfemoral angiographic bypass assessment. Postoperative MRI showed a small transient cerebellar ischemic lesion that resolved within 2 weeks. At 2 months, the patient was neurologically intact with patent bypass and no aneurysm recurrence. CONCLUSION: Hybrid occipital artery-AICA bypass followed by endovascular embolization is a feasible flow-preserving option for selected pediatric AICA aneurysms requiring distal perfusion preservation.
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Wang et al. (2026) conducted a case report in Radiation-induced dissecting anterior inferior cerebellar artery (AICA) a2 aneurysm (n=1). Hybrid occipital artery-AICA a3 bypass followed by endovascular coil embolization was evaluated on Aneurysm occlusion, bypass patency, and neurological status at 2 months. Hybrid occipital artery-AICA a3 bypass with coil embolization achieved complete aneurysm occlusion (Raymond-Roy Class I) and preserved neurological function at 2 months in a 13-year-old boy.
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