Characteristics and Endovascular Management of the Posterior Cerebral Artery Anterior Temporal Branch Aneurysms.

PURPOSE: To investigate characteristics of the posterior cerebral artery anterior temporal branch aneurysm and the safety and efficacy of endovascular management.

MATERIALS AND METHODS: A total of 6 patients with anterior temporal branch aneurysms were enrolled. All 6 patients had concurrent occlusion of the ipsilateral anterior circulating arteries. The aneurysms ranged from 2.5 to 5.0 mm. All patients were treated and followed up.

RESULTS: Four unruptured aneurysms were treated with coil embolization of the aneurysm sac only, with the parent artery maintained in 2 patients, slow flow in the parent artery in one and thrombosis at the aneurysm neck leading to parent artery occlusion in the last one. One patient with subarachnoid hemorrhage was treated with coil embolization of both the aneurysm and the parent artery, and the last patient with subarachnoid hemorrhage was treated with the Glubran 2 glue to embolize both the aneurysm and the parent artery. One patient with subarachnoid hemorrhage died of lung complication after embolization. Followed up for 3 months to 1 year, the 4 patients with unruptured aneurysms had no symptoms, including 1 patient with slow flow in the anterior temporal artery and 1 patient with thrombosis and parent artery occlusion. The remaining patient with parent artery occlusion had a good recovery.

CONCLUSIONS: The anterior temporal artery aneurysm is a special subtype of aneurysm and can be readily misdiagnosed as on the posterior cerebral artery trunk or the superior cerebellar artery. Endovascular management has a greater success rate, good effect, and fewer complications but with greater difficulties.