Clinical and Angiographic Follow-up of Stent-only Therapy for Acute Intracranial Vertebrobasilar Dissecting Aneurysms

Overview

Journal AJNR Am J Neuroradiol

Specialty Neurology

Date 2009 Apr 4

PMID 19342544

Citations 43

Authors

S I Park

B M Kim

D I Kim

Y S Shin

S H Suh

E C Chung

S Y Kim

S H Kim

Y S Won

Affiliations

Soon will be listed here.

Abstract

Background And Purpose: Little has been known about the clinical and angiographic follow-up results of stent-only therapy for intracranial vertebrobasilar dissecting aneurysms (VBDA). The purpose of this study was to evaluate the feasibility, safety, clinical, and angiographic follow-up of stent-only therapy for VBDA.

Materials And Methods: Twenty-seven patients with 29 VBDAs (11 ruptured, 18 unruptured), not suitable for deconstructive treatment, underwent stent-only therapy. Feasibility, safety, clinical, and angiographic follow-up were retrospectively evaluated. Angiographic outcomes were compared between single-stent and multiple-stent groups.

Results: All attempted stent placements were successfully accomplished without any treatment-related complication. Of the 11 ruptured VBDAs, 4 were treated by single stents, 6 by double overlapping stents, and 1 by triple overlapping stents. Of the 18 unruptured VBDAs, 6 were treated by stents, and 12 by double overlapping stents. One patient with a ruptured VBDA, treated by single stent, had rebleeding and died. None of the remaining patients had posttreatment bleeding during follow-up (mean, 28 months; range, 7-50 months). Eight patients with ruptured VBDA and all patients with unruptured VBDA had excellent outcomes (modified Rankin Scale, 0-1). The remaining 2 patients with ruptured VBDA were moderately disabled because of the initial damage. Angiographic follow-up was available in 27 VBDAs, 4 to 42 months (mean, 12 months) after treatment. Follow-up angiograms revealed complete obliteration of the dissecting aneurysm in 12, partial obliteration in 12, stable in 1, enlargement in 1, and in-stent occlusion in 1. Angiographic improvement (complete or partial obliteration) was more frequent in the multiple-stent group (17/17) than in the single-stent group (7/9; P < .05).

Conclusions: In this small series, stent-only therapy was safe and effective in the treatment of VBDAs that were not deemed suitable for treatment with parent-artery occlusion.

Citing Articles

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Clinical and Angiographic Outcomes of Endovascular Treatment for Acute Intracranial Vertebral Artery Dissecting Aneurysms Using Double-Overlapping Stents : Low-Profile Visualized Intraluminal Support within Enterprise Stents.

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Overlapping Stent Treatment for Ruptured Dissecting Aneurysms in Posterior Circulation.

Zhou M, Wu Z, Maalim A, Zeng Y, Guo X, Zhang Z Brain Sci. 2023; 13(11).

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A Case of Brainstem Infarction That Was Found to Be Vertebral Artery Dissection in a Short Period after the Diagnosis of Atherothrombotic Infarction.

Edaki H, Itami H, Ikushima K, Shinji Y, Otsuka S, Kusaka N J Neuroendovasc Ther. 2023; 14(10):428-434.

PMID: 37502663 PMC: 10370534. DOI: 10.5797/jnet.cr.2019-0117.

Low-profile visualized intraluminal support-within-Enterprise overlapping-stent technique versus flow diversion in the treatment of intracranial vertebrobasilar trunk dissecting aneurysms.

Wu Q, Wang C, Xu S, Ji Z, Qi J, Li Y Quant Imaging Med Surg. 2023; 13(6):3536-3546.

PMID: 37284083 PMC: 10239987. DOI: 10.21037/qims-22-970.

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