In situ suturing of a post-meatal segment of the anterior inferior cerebellar artery dissected by an aneurysm: A technical note

Abstract

Aneurysms originating along the peripheral portion of the anterior inferior cerebellar artery (AICA) are rare entities. As a result of the small diameter of the AICA, it is very challenging to preserve the parent artery during endovascular treatment for a peripheral AICA aneurysm. In this report, we present a rare case of aneurysm in the a2 segment of the right AICA. During surgery, the aneurysm was found to be a dissecting aneurysm. As the tissue of the aneurysm neck had a similar thickness to that of the adjacent normal vessel, interrupted suturing of the vessel was performed after partial removal and trimming of the aneurysm wall. The patient experienced an uneventful postoperative recovery. No other neurological deficit was noted. Magnetic resonance imaging three days after surgery revealed no acute ischaemia in the brainstem and cerebellum. Catheter angiography nine months later showed no recurrence of the aneurysm or stenosis of the AICA. The a2 segment of the AICA runs tortuously along the subarachnoid space of the cerebellopontine angle, which permits higher vascular mobility. In selected cases, in situ suturing or re-anastomosis could be considered for a2 segment aneurysms.