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Endovascular Treatment of Intracranial Vertebral Artery Dissecting Aneurysms: Follow up Angiographic and Clinical Results of Endovascular Treatment in Serial Cases.

Shin GW, Jeong HW - Neurointervention (2015)

Bottom Line: Immediate angiographic results revealed complete occlusion in 31 cases and incomplete occlusion in 14 cases.Endovascular treatment of intracranial VADA appears to be safe and effective.Follow-up angiographic study is needed because parent artery recanalization or aneurysmal recurrence can occur.

View Article: PubMed Central - PubMed

Affiliation: Department of Diagnostic Radiology, Busan Paik Hospital, Inje University, Busan, Korea.

ABSTRACT

Purpose: To report angiographic and clinical results of endovascular treatment in 45 intracranial vertebral artery dissecting aneurysms (VADAs).

Materials and methods: From July 2002 to September 2013, a total of 42 patients with 45 VADAs received endovascular treatment. Endovascular treatment consisted of internal trapping with detachable coils, stent-assisted coiling, and stenting only. Immediate and follow-up angiographic findings and clinical outcome were retrospectively reviewed.

Results: There were 17 ruptured VADAs and 28 unruptured VADAs. Overall, 26 VADAs were treated with internal trapping, 14 with stent-assisted coil embolization, and 5 with stenting only. Immediate angiographic results revealed complete occlusion in 31 cases and incomplete occlusion in 14 cases. Follow-up imaging studies were available in 31 cases. On follow-up imaging, antegrade recanalization occurred in 2 of 16 cases treated with internal trapping. Aneurysmal recurrence occurred in one case treated with stent-assisted coiling. Procedural complications occurred in 8 patients. In cases of unruptured VADA, favorable outcome (mRS 0 and 1) was achieved in 26 cases and poor outcome (mRS 2-5) in 2 cases. There was no mortality in patients with unruptured VADAs.

Conclusion: Endovascular treatment of intracranial VADA appears to be safe and effective. Follow-up angiographic study is needed because parent artery recanalization or aneurysmal recurrence can occur.

No MeSH data available.


Related in: MedlinePlus

A 41-year-old male with headache. A, B. Initial right vertebral angiogram and 3-dimensional reconstruction image of the right VA shows a dissecting aneurysm arising from the right VA. C. The double stent insertion without coil embolization in the affected right vertebral artery was done. D. Follow-up CT angiogram obtained after 11 months shows patent and improved blood flow with normalized vessel remodeling in stent inserted parent artery and its distal portion.
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Figure 4: A 41-year-old male with headache. A, B. Initial right vertebral angiogram and 3-dimensional reconstruction image of the right VA shows a dissecting aneurysm arising from the right VA. C. The double stent insertion without coil embolization in the affected right vertebral artery was done. D. Follow-up CT angiogram obtained after 11 months shows patent and improved blood flow with normalized vessel remodeling in stent inserted parent artery and its distal portion.

Mentions: Follow-up angiographic studies were available in 22 cases. In 9 cases treated with internal trapping, complete occlusion occurred in 8 cases and antegrade recanalization in 1 case. In 9 cases treated with stent-assisted coil embolization, complete occlusion with vessel remodeling occurred in 3 cases, no change in 5 cases, and recanalization in 1 case. Of these, a patient with recanalization on follow-up after stent-assisted coil embolization underwent retreatment with internal trapping using detachable coils (Fig.3). In cases treated with stenting only, complete occlusion with vessel remodeling occurred in 2 cases (Fig. 4), decrease of sac in size in 1 case, and no change in 1 case.


Endovascular Treatment of Intracranial Vertebral Artery Dissecting Aneurysms: Follow up Angiographic and Clinical Results of Endovascular Treatment in Serial Cases.

Shin GW, Jeong HW - Neurointervention (2015)

A 41-year-old male with headache. A, B. Initial right vertebral angiogram and 3-dimensional reconstruction image of the right VA shows a dissecting aneurysm arising from the right VA. C. The double stent insertion without coil embolization in the affected right vertebral artery was done. D. Follow-up CT angiogram obtained after 11 months shows patent and improved blood flow with normalized vessel remodeling in stent inserted parent artery and its distal portion.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4355641&req=5

Figure 4: A 41-year-old male with headache. A, B. Initial right vertebral angiogram and 3-dimensional reconstruction image of the right VA shows a dissecting aneurysm arising from the right VA. C. The double stent insertion without coil embolization in the affected right vertebral artery was done. D. Follow-up CT angiogram obtained after 11 months shows patent and improved blood flow with normalized vessel remodeling in stent inserted parent artery and its distal portion.
Mentions: Follow-up angiographic studies were available in 22 cases. In 9 cases treated with internal trapping, complete occlusion occurred in 8 cases and antegrade recanalization in 1 case. In 9 cases treated with stent-assisted coil embolization, complete occlusion with vessel remodeling occurred in 3 cases, no change in 5 cases, and recanalization in 1 case. Of these, a patient with recanalization on follow-up after stent-assisted coil embolization underwent retreatment with internal trapping using detachable coils (Fig.3). In cases treated with stenting only, complete occlusion with vessel remodeling occurred in 2 cases (Fig. 4), decrease of sac in size in 1 case, and no change in 1 case.

Bottom Line: Immediate angiographic results revealed complete occlusion in 31 cases and incomplete occlusion in 14 cases.Endovascular treatment of intracranial VADA appears to be safe and effective.Follow-up angiographic study is needed because parent artery recanalization or aneurysmal recurrence can occur.

View Article: PubMed Central - PubMed

Affiliation: Department of Diagnostic Radiology, Busan Paik Hospital, Inje University, Busan, Korea.

ABSTRACT

Purpose: To report angiographic and clinical results of endovascular treatment in 45 intracranial vertebral artery dissecting aneurysms (VADAs).

Materials and methods: From July 2002 to September 2013, a total of 42 patients with 45 VADAs received endovascular treatment. Endovascular treatment consisted of internal trapping with detachable coils, stent-assisted coiling, and stenting only. Immediate and follow-up angiographic findings and clinical outcome were retrospectively reviewed.

Results: There were 17 ruptured VADAs and 28 unruptured VADAs. Overall, 26 VADAs were treated with internal trapping, 14 with stent-assisted coil embolization, and 5 with stenting only. Immediate angiographic results revealed complete occlusion in 31 cases and incomplete occlusion in 14 cases. Follow-up imaging studies were available in 31 cases. On follow-up imaging, antegrade recanalization occurred in 2 of 16 cases treated with internal trapping. Aneurysmal recurrence occurred in one case treated with stent-assisted coiling. Procedural complications occurred in 8 patients. In cases of unruptured VADA, favorable outcome (mRS 0 and 1) was achieved in 26 cases and poor outcome (mRS 2-5) in 2 cases. There was no mortality in patients with unruptured VADAs.

Conclusion: Endovascular treatment of intracranial VADA appears to be safe and effective. Follow-up angiographic study is needed because parent artery recanalization or aneurysmal recurrence can occur.

No MeSH data available.


Related in: MedlinePlus