Endovascular treatment of a basilar artery dissecting aneurysm

Patroclo, Cristiane Borges; Puglia, Paulo; Leite, Cláudia da Costa; Yamamoto, Fábio Iuji; Ciríaco, Jovana Gobbi Marchesi; Scaff, Milberto; Conforto, Adriana Bastos

doi:10.1590/s0004-282x2007000600019

Cited by 5 publications

(4 citation statements)

References 19 publications

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“…online suppl. table 1, LC 66 and LC 87) [4,19]. Long-term prevention usually consists of low-dose ASA and occlusion of aneurysms in other vascular beds, which may have a higher than normal bleeding risk [1].…”

Section: Discussionmentioning

confidence: 99%

Basilar Artery Dissection: Series of 12 Consecutive Cases and Review of the Literature

et al. 2010

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Background: Current knowledge on primary or isolated basilar artery dissection (IBAD) is limited to case vignettes and small patient series. Objective: To delineate the frequency and clinical presentations of IBAD along with short-term outcome, specific prognosis and targeted management. Methods: Data were derived from a series of 12 consecutive patients and a review of 88 cases reported in the literature. In all the cases, the dissection was confined to the basilar artery. Results: Disease incidence was estimated at 0.25 per 100,000 person-years. IBAD accounted for roughly 1.0% of all subarachnoid hemorrhage events and for no less than 10.5 and 4.5% of posterior circulation and brain-supplying artery dissections, respectively. The main clinical presentations were subarachnoid hemorrhage (46%) and posterior circulation brain ischemia (42%). Subarachnoid hemorrhage typically manifested at a higher age than brain ischemia (mean age, 48.9 vs. 41.4 years) and was more prevalent among women. Rebleedings related to pseudoaneurysm formation in patients with subarachnoid hemorrhage and recurrent ischemia in stroke patients were common in the acute phase (26.1 and 33.3%, respectively) but were rare in the long term. The outcome was generally favorable in stroke patients but variable in subarachnoid hemorrhage (case fatality rate, 21.7%). The mainstay of therapy for subarachnoid hemorrhage related to IBAD was endovascular occlusion of the aneurysm pouch whereas stroke patients were usually put on anticoagulants. Conclusions: IBAD is probably an underrecognized disease with heterogeneous clinical presentation and prognosis. It should be considered as a differential diagnosis in peritruncal subarachnoid hemorrhage, classic subarachnoid hemorrhage and posterior circulation stroke, especially in young individuals. Case management is challenging and has to be tailored to each patient.

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Section: Discussionmentioning

confidence: 99%

Basilar Artery Dissection: Series of 12 Consecutive Cases and Review of the Literature

et al. 2010

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“…7 While surgery treatment is challenged by technical difficulties, 8 more and more reports of endovascular treatment with favorable outcomes have been published in recent years. [9][10][11][12][13][14][15][16] And it seemed stent placement (stent-assisted coiling or stent only) had a better outcome compared with coiling only. 11 In our center, we used stent placement treatment (with or without coiling) for patients with basilar artery dissection.…”

Section: Introductionmentioning

confidence: 99%

Stent treatment for basilar artery dissection: A single-center experience of 21 patients

Xue

et al. 2016

Interv Neuroradiol

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Basilar artery dissection is a rare disease with high morbidity and mortality. No well-established management strategy exists for this lesion. Endovascular reconstructive therapy using stents (with or without coiling) may be the optimum strategy. We describe our center’s experience for this treatment strategy in 21 patients with basilar artery dissection from January 2009 to July 2014 (17 men, four women; age range, 18–70 years; median age, 56 years). We divided patients into two groups: Group 1 patients received stent-assisted coiling treatment, and Group 2 patients received stent-only treatment. Pre-treatment, peri-operation and follow-up evaluation were investigated for complications, clinical outcome and angiographic results. The median follow-up time was 20 months (range, 3–67 months). All patients were treated endovascularly by stent-assisted coiling (14 patients) or stent only (seven patients). Immediate angiography showed: in Group 1, five of 14 lesions were completely occluded, five were partially occluded, four revealed retention of contrast media; in Group 2, all patients (seven of seven) had contrast retention. At the follow-up visit (median seven months, 3–29 months), the aneurysms were angiographically improved in five of 13 patients in Group 1 compared with immediately post-operation, while six of sevenimproved in Group 2. Five patients (all in Group 1) had ischemic or hemorrhage peri-operation complications. Long-term good clinical outcomes (modified Rankin Scale score (mRS) ≤ 2) were achieved in all patients except three death cases (two in Group1, one in Group 2). In our experience, endovascular reconstructive therapy using stents (with or without coiling) for basilar artery dissection is effective and safe. Stent-only treatment seems have a better safety profile during the peri-operation period.

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“…Surgical treatment has been considered the first choice for ruptured cerebral aneurysms associated with BD, especially saccular aneurysms of the middle cerebral artery 9 . However, endovascular treatment is a reasonable alternative to surgery in ruptured, peripherally located, fusiform-shaped, dissecting pseudo-aneurysms, and posterior circulation aneurysms, not only in BD 8 , but also in other settings 6,12 .…”

Section: Discussionmentioning

confidence: 99%

Dissecting Aneurysm of the Vertebral Artery and Behçet’s Disease

Laurenti¹,

Demartini²,

Santos³

et al. 2018

jbnc

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Behçet`s disease is characterized by a chronic multi-system and recurrent inflammatory condition. Central nervous system and vascular manifestations can be found late in the course. Rarely an association with intracranial aneurysms happen, if so, usually in the anterior circulation. We describe a case of Behçet`s disease associated with a dissecting aneurysm of the vertebral artery submitted to an endovascular treatment.

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Endovascular treatment of a basilar artery dissecting aneurysm

Cited by 5 publications

References 19 publications

Basilar Artery Dissection: Series of 12 Consecutive Cases and Review of the Literature

Basilar Artery Dissection: Series of 12 Consecutive Cases and Review of the Literature

Stent treatment for basilar artery dissection: A single-center experience of 21 patients

Dissecting Aneurysm of the Vertebral Artery and Behçet’s Disease

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