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Peer-reviewedCC BY-NC-ND 4.0Neurosurgery Practice

Hybrid Occipital Artery–AICA Bypass Followed by Endovascular Embolization for a Radiation-Induced Dissecting AICA Aneurysm in a Pediatric Patient

  • Xiaowen Wang1,2,3
  • Peixi Liu1,2,3
  • Revaz Shalibashvili4
  • Minyin Chai1,2,3
  • Yanlong Tian1,2,3
  • Zongze Li1,2,3
  • Yuan Shi1,2,3
  • Kun Song1,2,3
  • Tianming Qiu1,2,3
  • Wei Zhu1,2,3
4 affiliations
  1. 1Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
  2. 2National Center for Neurological Disorders, Shanghai, China
  3. 3Neurosurgical Institute, Fudan University, Shanghai, China
  4. 4Tbilisi State Medical University, Tbilisi, Georgia
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Abstract

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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Cite

BibTeXRIS
BibTeX
@article{wang2026hybrid,
  title = {{Hybrid Occipital Artery–AICA Bypass Followed by Endovascular Embolization for a Radiation-Induced Dissecting AICA Aneurysm in a Pediatric Patient}},
  author = {Xiaowen Wang and Peixi Liu and Revaz Shalibashvili and Minyin Chai and Yanlong Tian and Zongze Li and Yuan Shi and Kun Song and Tianming Qiu and Wei Zhu},
  journal = {Neurosurgery Practice},
  year = {2026},
  month = nov,
  doi = {10.1227/neuprac.0000000000000324},
  url = {https://doi.org/10.1227/neuprac.0000000000000324},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Hybrid Occipital Artery–AICA Bypass Followed by Endovascular Embolization for a Radiation-Induced Dissecting AICA Aneurysm in a Pediatric Patient
AU  - Xiaowen Wang
AU  - Peixi Liu
AU  - Revaz Shalibashvili
AU  - Minyin Chai
AU  - Yanlong Tian
AU  - Zongze Li
AU  - Yuan Shi
AU  - Kun Song
AU  - Tianming Qiu
AU  - Wei Zhu
PY  - 2026
DA  - 2026/11/05
JO  - Neurosurgery Practice
DO  - 10.1227/neuprac.0000000000000324
UR  - https://doi.org/10.1227/neuprac.0000000000000324
AB  - 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.
SN  - 2834-4383
ER  -