Kissing Aneurysms of the Posterior Inferior Cerebellar Artery Treated by Anchor Coil Technique and Stenting from the Contralateral Side: A Case Report

Kissing aneurysms refer to the condition in which two cerebral aneurysms with separate necks are in contact with each other. At present, there is scarce information on kissing aneurysms occurring near the vertebral artery (VA)-posterior inferior cerebellar artery (PICA). We report the first case of VA-PICA and nonbranched PICA kissing aneurysms, which were successfully treated with contralateral stenting after the anchor coil technique using two microcatheters. A 64-year-old woman was diagnosed with a left VA-PICA aneurysm (5.5 mm) and an adjacent small PICA aneurysm (2.5 mm) with the aneurysmal walls in close contact. For stenting, microcatheters were navigated to the PICA from the contralateral side, and framing coils for the anchor were placed into each aneurysm from the ipsilateral side. Next, a Neuroform Atlas stent was deployed from the PICA to the distal side of the VA, and coiling was completed using the jailing technique. The patient had a good postoperative course, and a left vertebral angiogram revealed complete occlusion of both aneurysms after 6 months. Adequate surgical planning and application of an appropriate stent-assisted coil embolization technique contributed to the success of the procedure in this rare case.