To evaluate the safety and clinical efficacy of endovascular treatment for acutely ruptured aneurysms located in the superior cerebellar artery.

A retrospective analysis was conducted on the clinical data of 34 patients with ruptured superior cerebellar artery aneurysms who underwent endovascular treatment at Neurosurgery Department of the First Affiliated Hospital of Harbin Medical University from October 2011 to October 2024. The incidence of in-hospital complications was evaluated. Clinical outcomes were assessed using the modified Rankin scale (MRS), and aneurysm occlusion status was evaluated according to the Raymond-Roy Occlusion Classification.

Among the 34 patients included in this study, 9 underwent stent-assisted coiling, whereas 25 were treated with simple coil embolization. In-hospital complications occurred in 11 patients (32.4%), including hemorrhagic complications in 4 patients (11.8%), with 1 in-hospital death (2.9%), ischemic complications in 5 patients (14.7%), and shunt-dependent hydrocephalus in 3 patients (8.8%). One patient developed both shunt-dependent hydrocephalus and a hemorrhagic complication. All 34 patients completed clinical follow-up, with a median follow-up duration of 41.5 (26.5-61.8) months. During follow-up, 3 patients (8.8%) experienced complications, including 2 patients (5.9%) who developed their first complication after discharge. Two patients (5.9%) suffered aneurysm rebleeding during follow-up, resulting in death in one patient and cerebral infarction in the other. The overall mortality rate in this cohort was 8.8% (3/34). Angiographic follow-up was available for 24 patients, with a median follow-up duration of 9 (6-12) months. According to the Raymond-Roy occlusion classification, complete occlusion (Grade Ⅰ) was achieved in 20 patients (83.3%), residual neck (Grade Ⅱ) was observed in 3 patients (12.5%), and residual aneurysm (Grade Ⅲ) was identified in 1 patient (4.2%).

Endovascular treatment for acutely ruptured superior cerebellar artery aneurysms is feasible and demonstrates favorable clinical efficacy. However, procedure-related and disease-related complications remain a significant concern and warrant close attention.