{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T17:57:33Z","timestamp":1784829453857,"version":"3.55.0"},"reference-count":40,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"18","license":[{"start":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T00:00:00Z","timestamp":1762128000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2025,11,3]]},"abstract":"\n BACKGROUND<\/jats:title>\n Aneurysms of the fetal-type posterior cerebral artery (FPCA) are rare and often present with fusiform or dissecting morphology. Unlike the adult-type posterior cerebral artery (PCA), the FPCA can only be accessed through the internal carotid artery, limiting endovascular routes and device options. These anatomical and technical constraints often necessitate parent artery occlusion (PAO) as a treatment strategy; however, it carries a substantial risk of ischemic complications. The authors report a rare case of a ruptured FPCA aneurysm with ipsilateral P1 segment aplasia, treated successfully with stent-assisted coil embolization with preservation of anterograde FPCA flow.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n A 79-year-old woman presented with subarachnoid hemorrhage and impaired consciousness. Imaging revealed a fusiform aneurysm along the FPCA and aplasia of the ipsilateral P1 segment. Because of narrow vessel anatomy, dual microcatheter techniques were not feasible. After conservative management, the patient underwent stent-assisted coil embolization via a transcellular approach. The aneurysm was completely obliterated with preserved FPCA flow, and no ischemic complications occurred.<\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n A literature review suggests that aneurysms with saccular configuration and proximity to the P2 segment are favorable for selective coil embolization. Given the high risk of thalamic and occipital infarction associated with PAO, preserving FPCA flow should be prioritized when anatomically and technically feasible.<\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE25556<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case25556","type":"journal-article","created":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T00:06:53Z","timestamp":1762214813000},"source":"Crossref","is-referenced-by-count":3,"title":["Feasibility of endovascular treatment for fetal-type posterior cerebral artery aneurysm with P1 segment aplasia: illustrative case"],"prefix":"10.3171","volume":"10","author":[{"given":"Jun-ichi","family":"Nomura","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Moriya Dai-ichi General Hospital, Moriya, Ibaraki"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6660-9316","authenticated-orcid":true,"given":"Taichi","family":"Ishiguro","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tokyo Women\u2019s Medical University Yachiyo Medical Center, Yachiyo, Chiba"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenichi","family":"Hodotsuka","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Moriya Dai-ichi General Hospital, Moriya, Ibaraki"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takakazu","family":"Kawamata","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tokyo Women\u2019s Medical University, Shinjuku, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"4","key":"bib1","series-title":"Cerebrovasc Dis","first-page":"217","article-title":"The fetal variant of the circle of Willis and its influence on the cerebral collateral circulation","volume":"22","author":"van Raamt","year":"2006","unstructured":"van Raamt AFMali WPvan Laar PJvan der Graaf Y.The fetal variant of the circle of Willis and its influence on the cerebral collateral circulation. Cerebrovasc Dis. 2006;22(4):217-224."},{"issue":"3","key":"bib2","series-title":"Clin Imaging","first-page":"221","article-title":"The study of fetal-type posterior cerebral circulation on multislice CT angiography and its influence on cerebral ischemic strokes","volume":"38","author":"Arjal","year":"2014","unstructured":"Arjal RKZhu TZhou Y.The study of fetal-type posterior cerebral circulation on multislice CT angiography and its influence on cerebral ischemic strokes. Clin Imaging. 2014;38(3):221-225."},{"issue":"3","key":"bib3","series-title":"Anat Cell Biol","first-page":"272","article-title":"Incidence of hypoplastic posterior communicating artery and fetal posterior cerebral artery in Andhra population of India: a retrospective 3-Tesla magnetic resonance angiographic study","volume":"53","author":"Bhanu","year":"2020","unstructured":"Bhanu SPPentyala SSankar DK.Incidence of hypoplastic posterior communicating artery and fetal posterior cerebral artery in Andhra population of India: a retrospective 3-Tesla magnetic resonance angiographic study. Anat Cell Biol. 2020;53(3):272-278."},{"key":"bib4","series-title":"Anat Res Int","article-title":"Study of posterior cerebral artery in human cadaveric brain","volume":"2015","author":"Gunnal","year":"2015","unstructured":"Gunnal SAFarooqui MSWabale RN.Study of posterior cerebral artery in human cadaveric brain. Anat Res Int. 2015;2015:681903."},{"issue":"2","key":"bib5","series-title":"Medicina (Kaunas)","first-page":"231","article-title":"The fetal type of posterior cerebral artery","volume":"59","author":"Davidoiu","year":"2023","unstructured":"Davidoiu AMMinc\u0103 DIRusu MCHostiuc SToader C.The fetal type of posterior cerebral artery. Medicina (Kaunas). 2023;59(2):231."},{"issue":"2","key":"bib6","series-title":"Neuroradiology","first-page":"128","article-title":"Dissecting aneurysms of the posterior cerebral artery: angioarchitecture and a review of the literature","volume":"42","author":"Lazinski","year":"2000","unstructured":"Lazinski DWillinsky RATerBrugge KMontanera W.Dissecting aneurysms of the posterior cerebral artery: angioarchitecture and a review of the literature. 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Interv Neuroradiol. 2011;17(2):159-168."},{"key":"bib11","series-title":"Front Neurol","first-page":"38","article-title":"Dissecting aneurysms of posterior cerebral artery: clinical presentation, angiographic findings, treatment, and outcome","volume":"2","author":"Taqi","year":"2011","unstructured":"Taqi MALazzaro MAPandya DJBadruddin AZaidat OO.Dissecting aneurysms of posterior cerebral artery: clinical presentation, angiographic findings, treatment, and outcome. Front Neurol. 2011;2:38."},{"issue":"2","key":"bib12","series-title":"J Neurosurg","first-page":"284","article-title":"Potential proneness of fetal-type posterior cerebral artery to vascular insufficiency in parent vessel occlusion of distal posterior cerebral artery aneurysms","volume":"117","author":"Lv","year":"2012","unstructured":"Lv XLi YYang XJiang CWu Z.Potential proneness of fetal-type posterior cerebral artery to vascular insufficiency in parent vessel occlusion of distal posterior cerebral artery aneurysms. 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J Clin Neurosci. 2016;32:41-46."},{"issue":"4","key":"bib15","series-title":"NMC Case Rep J","first-page":"129","article-title":"Super-selective balloon test occlusion of the posterior communicating artery in the treatment of a posterior cerebral artery fusiform aneurysm: a case report","volume":"3","author":"Isozaki","year":"2016","unstructured":"Isozaki MArai HNeishi HKitai RKikuta KI.Super-selective balloon test occlusion of the posterior communicating artery in the treatment of a posterior cerebral artery fusiform aneurysm: a case report. NMC Case Rep J. 2016;3(4):129-131."},{"key":"bib16","series-title":"World Neurosurg","first-page":"521","article-title":"Posterior cerebral artery aneurysms: treatment and outcome analysis in 121 patients","volume":"92","author":"Goehre","year":"2016","unstructured":"Goehre FJahromi BRLehecka MPosterior cerebral artery aneurysms: treatment and outcome analysis in 121 patients. World Neurosurg. 2016;92:521-532."},{"issue":"4","key":"bib17","series-title":"J Neurosurg","first-page":"1094","article-title":"Endovascular treatment of posterior cerebral artery aneurysms: a single center\u2019s experience of 55 cases","volume":"126","year":"2017","unstructured":"QinXXuFMaimaitiY, et al. Endovascular treatment of posterior cerebral artery aneurysms: a single center\u2019s experience of 55 cases. J Neurosurg. 2017;126(4):1094-1105."},{"issue":"1","key":"bib18","series-title":"Neuroradiol J","first-page":"128","article-title":"Endovascular treatment of posterior cerebral artery aneurysms","volume":"21","author":"Li","year":"2008","unstructured":"Li YLv XJiang CLiu AWu Z.Endovascular treatment of posterior cerebral artery aneurysms. Neuroradiol J. 2008;21(1):128-136."},{"issue":"5","key":"bib19","series-title":"J Neurol Neurosurg Psychiatry","first-page":"584","article-title":"Posterior cerebral artery dissecting aneurysm: another cause of perimesencephalic pattern of subarachnoid haemorrhage","volume":"82","author":"Pita Lobo","year":"2011","unstructured":"Pita Lobo PCampos JNeto LCanh\u00e3o P.Posterior cerebral artery dissecting aneurysm: another cause of perimesencephalic pattern of subarachnoid haemorrhage. J Neurol Neurosurg Psychiatry. 2011;82(5):584-585."},{"key":"bib20","series-title":"Front Neurol","first-page":"746525","article-title":"Endovascular treatment of posterior cerebral artery trunk aneurysm: the status quo and dilemma","volume":"12","author":"Hou","year":"2021","unstructured":"Hou KLv XYu J.Endovascular treatment of posterior cerebral artery trunk aneurysm: the status quo and dilemma. Front Neurol. 2021;12:746525."},{"issue":"4","key":"bib1","series-title":"Cerebrovasc Dis","first-page":"217","article-title":"The fetal variant of the circle of Willis and its influence on the cerebral collateral circulation","volume":"22","author":"van Raamt","year":"2006","unstructured":"van Raamt AFMali WPvan Laar PJvan der Graaf Y.The fetal variant of the circle of Willis and its influence on the cerebral collateral circulation. Cerebrovasc Dis. 2006;22(4):217-224."},{"issue":"3","key":"bib2","series-title":"Clin Imaging","first-page":"221","article-title":"The study of fetal-type posterior cerebral circulation on multislice CT angiography and its influence on cerebral ischemic strokes","volume":"38","author":"Arjal","year":"2014","unstructured":"Arjal RKZhu TZhou Y.The study of fetal-type posterior cerebral circulation on multislice CT angiography and its influence on cerebral ischemic strokes. Clin Imaging. 2014;38(3):221-225."},{"issue":"3","key":"bib3","series-title":"Anat Cell Biol","first-page":"272","article-title":"Incidence of hypoplastic posterior communicating artery and fetal posterior cerebral artery in Andhra population of India: a retrospective 3-Tesla magnetic resonance angiographic study","volume":"53","author":"Bhanu","year":"2020","unstructured":"Bhanu SPPentyala SSankar DK.Incidence of hypoplastic posterior communicating artery and fetal posterior cerebral artery in Andhra population of India: a retrospective 3-Tesla magnetic resonance angiographic study. Anat Cell Biol. 2020;53(3):272-278."},{"key":"bib4","series-title":"Anat Res Int","article-title":"Study of posterior cerebral artery in human cadaveric brain","volume":"2015","author":"Gunnal","year":"2015","unstructured":"Gunnal SAFarooqui MSWabale RN.Study of posterior cerebral artery in human cadaveric brain. Anat Res Int. 2015;2015:681903."},{"issue":"2","key":"bib5","series-title":"Medicina (Kaunas)","first-page":"231","article-title":"The fetal type of posterior cerebral artery","volume":"59","author":"Davidoiu","year":"2023","unstructured":"Davidoiu AMMinc\u0103 DIRusu MCHostiuc SToader C.The fetal type of posterior cerebral artery. Medicina (Kaunas). 2023;59(2):231."},{"issue":"2","key":"bib6","series-title":"Neuroradiology","first-page":"128","article-title":"Dissecting aneurysms of the posterior cerebral artery: angioarchitecture and a review of the literature","volume":"42","author":"Lazinski","year":"2000","unstructured":"Lazinski DWillinsky RATerBrugge KMontanera W.Dissecting aneurysms of the posterior cerebral artery: angioarchitecture and a review of the literature. Neuroradiology. 2000;42(2):128-133."},{"issue":"12","key":"bib7","series-title":"Acta Neurochir (Wien)","first-page":"1583","article-title":"Results of surgical management for posterior cerebral artery aneurysms: 7-year experience in the endovascular era","volume":"151","author":"Kocaeli","year":"2009","unstructured":"Kocaeli HChaalala CAbruzzo TAZuccarello M.Results of surgical management for posterior cerebral artery aneurysms: 7-year experience in the endovascular era. Acta Neurochir (Wien). 2009;151(12):1583-1591."},{"issue":"3","key":"bib8","series-title":"Interv Neuroradiol","first-page":"341","article-title":"Endovascular management for p2 aneurysms of the posterior cerebral artery. Experience on proximal occlusion of the p2 segmen","volume":"15","author":"Lv","year":"2009","unstructured":"Lv XLi YJiang CWu Z.Endovascular management for p2 aneurysms of the posterior cerebral artery. Experience on proximal occlusion of the p2 segmen. Interv Neuroradiol. 2009;15(3):341-348."},{"issue":"1","key":"bib9","series-title":"Neurosurgery","first-page":"16","article-title":"Treatment of distal posterior cerebral artery aneurysms: a critical appraisal of the occipital artery-to-posterior cerebral artery bypass","volume":"67","author":"Chang","year":"2010","unstructured":"Chang SWAbla AAKakarla UKTreatment of distal posterior cerebral artery aneurysms: a critical appraisal of the occipital artery-to-posterior cerebral artery bypass. Neurosurgery. 2010;67(1):16-26."},{"issue":"2","key":"bib10","series-title":"Interv Neuroradiol","first-page":"159","article-title":"Deliberate parent artery occlusion for non-saccular posterior cerebral artery aneurysms","volume":"17","author":"Liu","year":"2011","unstructured":"Liu LHe HJiang CLv XLi Y.Deliberate parent artery occlusion for non-saccular posterior cerebral artery aneurysms. Interv Neuroradiol. 2011;17(2):159-168."},{"key":"bib11","series-title":"Front Neurol","first-page":"38","article-title":"Dissecting aneurysms of posterior cerebral artery: clinical presentation, angiographic findings, treatment, and outcome","volume":"2","author":"Taqi","year":"2011","unstructured":"Taqi MALazzaro MAPandya DJBadruddin AZaidat OO.Dissecting aneurysms of posterior cerebral artery: clinical presentation, angiographic findings, treatment, and outcome. Front Neurol. 2011;2:38."},{"issue":"2","key":"bib12","series-title":"J Neurosurg","first-page":"284","article-title":"Potential proneness of fetal-type posterior cerebral artery to vascular insufficiency in parent vessel occlusion of distal posterior cerebral artery aneurysms","volume":"117","author":"Lv","year":"2012","unstructured":"Lv XLi YYang XJiang CWu Z.Potential proneness of fetal-type posterior cerebral artery to vascular insufficiency in parent vessel occlusion of distal posterior cerebral artery aneurysms. J Neurosurg. 2012;117(2):284-287."},{"issue":"4","key":"bib13","series-title":"J Neurosurg","first-page":"906","article-title":"Fetal-type posterior cerebral artery: the pitfall of parent artery occlusion for ruptured P2 segment and distal aneurysms","volume":"123","author":"Xu","year":"2015","unstructured":"Xu JXu LWu ZChen XYu JZhang J.Fetal-type posterior cerebral artery: the pitfall of parent artery occlusion for ruptured P2 segment and distal aneurysms. J Neurosurg. 2015;123(4):906-914."},{"key":"bib14","series-title":"J Clin Neurosci","first-page":"41","article-title":"Endovascular treatments for posterior cerebral artery aneurysms and vascular insufficiency of fetal-type circulation after parent artery occlusion","volume":"32","author":"Matsumura","year":"2016","unstructured":"Matsumura HKato NFujiwara YEndovascular treatments for posterior cerebral artery aneurysms and vascular insufficiency of fetal-type circulation after parent artery occlusion. J Clin Neurosci. 2016;32:41-46."},{"issue":"4","key":"bib15","series-title":"NMC Case Rep J","first-page":"129","article-title":"Super-selective balloon test occlusion of the posterior communicating artery in the treatment of a posterior cerebral artery fusiform aneurysm: a case report","volume":"3","author":"Isozaki","year":"2016","unstructured":"Isozaki MArai HNeishi HKitai RKikuta KI.Super-selective balloon test occlusion of the posterior communicating artery in the treatment of a posterior cerebral artery fusiform aneurysm: a case report. NMC Case Rep J. 2016;3(4):129-131."},{"key":"bib16","series-title":"World Neurosurg","first-page":"521","article-title":"Posterior cerebral artery aneurysms: treatment and outcome analysis in 121 patients","volume":"92","author":"Goehre","year":"2016","unstructured":"Goehre FJahromi BRLehecka MPosterior cerebral artery aneurysms: treatment and outcome analysis in 121 patients. World Neurosurg. 2016;92:521-532."},{"issue":"4","key":"bib17","series-title":"J Neurosurg","first-page":"1094","article-title":"Endovascular treatment of posterior cerebral artery aneurysms: a single center\u2019s experience of 55 cases","volume":"126","year":"2017","unstructured":"QinXXuFMaimaitiY, et al. Endovascular treatment of posterior cerebral artery aneurysms: a single center\u2019s experience of 55 cases. J Neurosurg. 2017;126(4):1094-1105."},{"issue":"1","key":"bib18","series-title":"Neuroradiol J","first-page":"128","article-title":"Endovascular treatment of posterior cerebral artery aneurysms","volume":"21","author":"Li","year":"2008","unstructured":"Li YLv XJiang CLiu AWu Z.Endovascular treatment of posterior cerebral artery aneurysms. Neuroradiol J. 2008;21(1):128-136."},{"issue":"5","key":"bib19","series-title":"J Neurol Neurosurg Psychiatry","first-page":"584","article-title":"Posterior cerebral artery dissecting aneurysm: another cause of perimesencephalic pattern of subarachnoid haemorrhage","volume":"82","author":"Pita Lobo","year":"2011","unstructured":"Pita Lobo PCampos JNeto LCanh\u00e3o P.Posterior cerebral artery dissecting aneurysm: another cause of perimesencephalic pattern of subarachnoid haemorrhage. J Neurol Neurosurg Psychiatry. 2011;82(5):584-585."},{"key":"bib20","series-title":"Front Neurol","first-page":"746525","article-title":"Endovascular treatment of posterior cerebral artery trunk aneurysm: the status quo and dilemma","volume":"12","author":"Hou","year":"2021","unstructured":"Hou KLv XYu J.Endovascular treatment of posterior cerebral artery trunk aneurysm: the status quo and dilemma. 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