Transcirculation retrograde deployment of Neuroform Atlas stent-assisted coil embolization for a superior cerebellar artery aneurysm

Superior cerebellar artery (SCA) aneurysms are rare, accounting for only 1%-2% of all intracranial aneurysms, and are predominantly wide-necked. Due to the typically acute angle between the SCA and the basilar artery, stent delivery to the SCA through the basilar artery in an anterograde approach is technically challenging. In contrast, accessing the SCA from the anterior circulation through the posterior communicating artery is considerably more feasible. This approach to guiding a microcatheter from the anterior to the posterior circulation is called the transcirculation technique. Notably, the stent could be deployed across the entire length of the aneurysm neck via transcirculation, ensuring effective coverage of the target aneurysm. Herein, we present a case of an SCA aneurysm successfully treated with the transcirculation technique (Video 1). This approach may represent a promising alternative for treating wide-necked SCA aneurysms in selected cases with an acute angle between the SCA and the basilar artery. The procedure was performed following informed consent.