Abstract: Objective To explore the efficacy and safety of surgical management in intracranial aneurysms of the distal posterior circulation. Methods Clinical data of 16 patients with intracranial aneurysms of the distal posterior circulation who underwent surgical or interventional management were retrospectively reviewed. The locations of the aneurysms included: 1 posterior choroidal artery(PChA), 2 posterior cerebral arteries(PCA), 3 superior cerebellar arteries(SCA), 4 anterior inferior cerebellar arteries(AICA), and 8 posterior inferior cerebellar arteries(PICA)in 6 patients. Results The parent arteries of 4 patients who received micro-coil embolization remained patent; the parent arteries of 7 patients who received Onyx with or without micro-coil were obstructed; the 7 aneurysms in 5 cases were clipped. Asymptomatic cerebellar infarction occurred in 3 cases. DSA or CTA follow-up in 11 cases showed no recurrence. Conclusion Due to the sufficient collateral circulation and anatomic variation, brain stem infarction resulted from occlusion is rarely seen. Saccular aneurysm in the front or outside of brain stem should be managed with parent artery preservation. Occlusion of the parent artery of aneurysms of the distal posterior circulation is safe and efficient.

Key words: Posterior circulation, Intracranial aneurysm, Parent artery occlusion