Clinical and Angiographic Follow-Up of Stent-Only Therapy for Acute Intracranial Vertebrobasilar Dissecting Aneurysms

Park, S. I.; Kim, Byung Moon; Kim, D. I.; Shin, Yong Sam; Suh, Sang Hyun; Chung, Eun Chul; Kim, S. Y.; Won, Yu Sam

doi:10.3174/ajnr.a1561

Cited by 116 publications

(117 citation statements)

References 35 publications

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“…It is well known that stent placement decreases wall shear stress in the aneurysm wall in proportion to the number of overlapping stents. 21,22 As in many previous case studies, 4,5,9,[23][24][25][26] this study showed promising results for the use of multiple overlapping stents, with or without coiling, in the treatment of VBDAs. Newly developed flow diverters, which have far less porosity than conventional neurovascular or coronary stents, may play a decisive role in reconstructive treatment of VBDAs.…”

Section: Discussionsupporting

confidence: 48%

“…The patient showed an enlarged dissecting aneurysm on follow-up angiography and was re-treated with IT, as previously reported. 5 The other received a single stent with coiling for a VBDA that involved the PICA origin; SAH recurred in this patient 3 days after treatment. The patient did not receive follow-up angiography due to poor condition and subsequently died.…”

Section: Resultsmentioning

confidence: 99%

“…20 However, if the contralateral PICA is absent and the ipsilateral, anterior inferior cerebellar artery is hypoplastic, the occlusion of the affected PICA in ruptured VBDAs may cause a large cerebellar infarct, requiring posterior craniectomy for decompression. 5 Therefore, under such anatomic conditions, an occipital artery-PICA bypass surgery may be performed. Additional study on IT including the PICA origin for treatment of ruptured VBDAs is required.…”

Section: Discussionmentioning

confidence: 99%

“…В настоящее время эндоваскулярное вмешательство является основным методом лечения аневризм Берри внутричерепных сосудов. Применительно к РАВБАС эндоваскулярное лечение улучшает клинические исходы заболевания [3][4][5]. Широко обсуждаются частота развития реци-дивов и факторы риска развития рецидива после эндоваскулярного лечения аневризм Берри [6].…”

Section: ключевые слова: аневризма (Aneurysm) диссекция (Dissection)unclassified

“…Applied to the intracranial VBDA, endovascular treatment has improved clinical outcomes. [3][4][5] Recurrence rates and risk factors for recurrence after endovascular treatment in intracranial Berry aneurysms have been widely discussed. 6 The aim of this study was to retrospectively evaluate the incidence and risk factors for recurrence after endovascular treatment for intracranial VBDAs.…”

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confidence: 99%

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Incidence and Risk Factors of Recurrence After Endovascular Treatment of Intracranial Vertebrobasilar Dissecting Aneurysms

Kim

Shin

Kim

et al. 2011

Stroke

117

143

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Background and Purpose-The incidence and risk factors for recurrence after endovascular treatment of intracranial vertebrobasilar dissecting aneurysms (VBDAs) have not been studied. We aimed to evaluate the incidence and risk factors for recurrence after endovascular treatment of VBDAs. Methods-A total of 111 patients (mean age, 45Ϯ10 years) underwent endovascular treatment for 119 VBDAs (ruptured/unrupturedϭ73:46). Incidence and risk factors for recurrence were retrospectively evaluated. Results-Sixty-two VBDAs were treated by a reconstructive technique by using 1 to 3 overlapping stents with or without coiling, and 57 VBDAs were treated by a deconstructive technique by using proximal occlusion or internal trapping at the dissected segment of the parent artery. Follow-up angiography was available for 97 VBDAs (81.5%) in 89 patients at 3 days to 48 months (median, 13 months) after treatment. There were 13 recurrences: 6 had rebleeding but 7 had no rebleeding. All 6 hemorrhagic recurrences had initially presented with a ruptured form. Ten recurrences were confirmed by angiography, but 3 recurrences with rebleeding did not receive follow-up angiography. The rate of post-treatment recurrence did not differ between reconstructive and deconstructive treatments. Involvement of the posterior inferior cerebellar artery origin (odds ratioϭ8.026; 95% confidence interval, 1.561 to 41.259; Pϭ0.013) was the only independent risk factor for recurrence. Conclusions-There was a 13% recurrence after endovascular treatment of VBDAs. Posterior inferior cerebellar artery origin involvement was the only independent risk factor for recurrence after endovascular treatment of VBDAs. (Stroke. 2011;42:2425-2430.)

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