Flow Diversion Treatment of a Dissecting Aneurysm of the Posterior Inferior Cerebellar Artery (PICA)
Rouslan Senkeev1, Davide Castellano2, Chiara Comelli2, Daniele Savio2, Andrea Boghi2*
1Department of Oncology, University of Turin, Italy.
2Interventional Radiology Unit – San Giovanni Bosco Hospital (ASL Città di Torino), Italy.
*Corresponding Author: Andrea Boghi, Interventional Radiology Unit – San Giovanni Bosco Hospital (ASL Città di Torino), Italy.
https://doi.org/10.58624/SVOANE.2026.07.003
Received: December 02, 2025
Published: January 23, 2026
Citation: Senkeev R, Castellano D, Comelli C, Savio D, Boghi A. Flow Diversion Treatment of a Dissecting Aneurysm of the Posterior Inferior Cerebellar Artery (PICA). SVOA Neurology 2026, 7:1, 15-18. doi. 10.58624/SVOANE.2026.07.003
Abstract
Background: Intracranial dissecting aneurysms are uncommon conditions and those involving the posterior inferior cerebellar artery (PICA) are particularly rare. Historically, therapeutic strategies relied on parent vessel occlusion. Only in recent years, the introduction of flow diverters (FDs) expanded treatment possibilities, allowing for aneurysm exclusion even in small-caliber vessels while preserving arterial patency.
Case Presentation: A patient in his 50s presented with acute headache secondary to subarachnoid haemorrhage caused by a dissecting aneurysm of the posterior inferior cerebellar artery (PICA). Angiography confirmed a fusiform dissecting aneurysm at the PICA origin from the dominant left vertebral artery. The aneurysm was successfully treated with two hydrophilic-coated flow diverter stents (Phenox p48 HPC), achieving vessel reconstruction and preservation of PICA patency. Dual antiplatelet therapy was administered to mitigate thrombogenic risk. Follow-up imaging demonstrated progressive aneurysm exclusion and complete vessel healing without complications.
Conclusions: Flow diversion is a feasible and safe treatment option for ruptured dissecting PICA aneurysms. This approach provides an effective alternative to vessel sacrifice while reducing the risk of brainstem infarction and Wallenberg syndrome.
Keywords: Interventional Neuroradiology, Posterior Inferior Cerebellar Artery (PICA), Intracranial aneurysm, Flow Diverter, Subarachnoid Hemorrhage (SAH)
