Endovascular Treatment of a Vertebral Artery Aneurysm via Puncture of the Surgically Exposed Vertebral Artery

Oka, Fumiaki; Ishihara, Hideaki; Kato, Shunsuke; Shinoyama, Mizuya

doi:10.1177/159101991101700112

Cited by 10 publications

(6 citation statements)

References 4 publications

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“…Of those, we acquired 112 reports with full text. Of the 112, 20 studies described the number of coils used and so were eligible for inclusion in the present study [2,3,[6][7][8][14][15][16][17][18][19][20][21]27,[32][33][34][35]38]. We performed a systematic review using the 20 studies, which comprised 33 cases.…”

Section: Literature Review Resultsmentioning

confidence: 99%

Number of Coils for Parent Artery Occlusion of Ruptured Vertebral Artery Dissecting Aneurysm Delta Coil Case Series and Literature Review

Suzuki¹

2019

OAJNN

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Background: Parent Artery Occlusion (PAO) by simple coiling for Vertebral Artery Dissection (VAD) sometimes needs a large number of coils, increasing both operative time and medical costs. DELTA coils (Johnson and Johnson, USA) provide a homogenous coil distribution and high packing density due to their triangular shape. They have the potential to decrease the number of coils used in PAO. In this study, we retrospectively investigated the number of coils required for PAO using the simple coiling to treat VAD-induced Subarachnoid Hemorrhage (SAH). Methods:We analyzed 11 of our own SAH patients who underwent PAO for VAD by simple coiling. A literature search was performed using PubMed and Japan Medical Abstracts Society for VAD, endovascular treatment, and coil. Results:The mean number of coils used in our hospital was 6.8 (3-10); the mean operative time was 77.8 (49-140) minutes. In the literature review, 20 of the 112 acquired reports stated the number of coils used for PAO by simple coiling for VAD-induced SAH. Of the 33 cases in the 20 reports, the mean number of coils used was 10.4 (3-60). Conclusion:DELTA coils and their characteristic triangular shape have the possibility to save medical costs by reducing the number of coils used for PAO.

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Section: Literature Review Resultsmentioning

confidence: 99%

Number of Coils for Parent Artery Occlusion of Ruptured Vertebral Artery Dissecting Aneurysm Delta Coil Case Series and Literature Review

Suzuki¹

2019

OAJNN

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“…It is relatively convenient to expose the V1 segment, and the C4 transverse foramen can be used as the marker during separation. Oka et al 11 reported a patient with a ruptured RVA aneurysm. The aneurysm was successfully embolized by exposing and puncturing the vertebral artery at the level of the C4 vertebral body.…”

Section: Discussionmentioning

confidence: 99%

Vertebral artery course variation leading to an insufficient proximal anchoring area for thoracic endovascular aortic repair

Lyu

Lang

et al. 2022

Vascular

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Backgrounds We aimed to demonstrate the feasibility of thoracic endovascular aortic repair for type B aortic dissection in patients with an insufficient proximal anchoring area due to the vertebral artery originating from the aortic arch. Methods In this study, we report two patients with type B aortic dissection who were complicated with left vertebral artery course variation. Specifically, the left vertebral artery originated from the aortic arch. In these patients, the anchoring area (<15 mm) was not sufficient between the left vertebral artery and the ruptured aortic dissection. Result We reconstructed the left vertebral artery during horacic endovascular aortic repair. Both patients recovered well and were discharged without any adverse events. Conclution Our experience shows that horacic endovascular aortic repair is feasible in patients with type B aortic dissection who have an insufficient proximal anchoring area due to the left vertebral artery originating from the aortic arch.

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“…The reported complication rates related to percutaneous or direct access approaches range from 0% to 50%. [7][8][9][10][11][12][13] The major complications include hematoma, arteriovenous fistula, pseudoaneurysm, and thrombosis. However, the benefits of aneurysm obliteration and reduction of future rupture risk outweigh the potential risks of direct vertebral artery access.…”

Section: Discussionmentioning

confidence: 99%

“…The case reports reporting direct puncture typically describe percutaneous access. [7][8][9][10][11][12] Only one recent case series detailed 3 cases of direct surgical access to the V1 segment for basilar aneurysms. 13 The one unsuccessful coiling resulted from an inability to insert the sheath due to the angle of access to the V1 segment.…”

Section: Discussionmentioning

confidence: 99%

Direct Vertebral Artery Access for Coil Embolization of a Partially Thrombosed Mid-Basilar Trunk Aneurysm: Technical Limitations

Miller

Felbaum

Liu

et al. 2021

ONSURG

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BACKGROUND AND IMPORTANCE Partially thrombosed basilar aneurysms have a high morbidity from the rupture risk and mass effect prompting early treatment. Depending on the size and location, they pose a surgical challenge often requiring multiple endovascular treatment modalities. Here we present a partially thrombosed mid-basilar aneurysm successfully coil embolized with direct vertebral artery access and discuss the technical limitations of direct V1 access. CLINICAL PRESENTATION A 70-yr-old woman presented with acute onset headache, nausea, and vomiting. A computed tomography (CT) head demonstrated a hyperdense prepontine mass which was further characterized as a partially thrombosed basilar aneurysm on CT angiography. After multiple failed attempts to access the vertebral artery via femoral and radial access the patient was taken to the operating room (OR) for surgical exposure of the right V1 segment and direct cannulation of the vertebral artery. The aneurysm was successfully coiled and the vertebral artery closed primarily. The patient was discharged home without any neurological deficits. CONCLUSION Partially thrombosed mid-basilar aneurysms are difficult to treat both surgically and endovascularly. We present a case where endovascular access to the aneurysm was very challenging requiring direct exposure and cannulation of the V1 segment to successfully embolize with coils and discuss the technical limitations of this approach.

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Endovascular Treatment of a Vertebral Artery Aneurysm via Puncture of the Surgically Exposed Vertebral Artery

Cited by 10 publications

References 4 publications

Number of Coils for Parent Artery Occlusion of Ruptured Vertebral Artery Dissecting Aneurysm Delta Coil Case Series and Literature Review

Number of Coils for Parent Artery Occlusion of Ruptured Vertebral Artery Dissecting Aneurysm Delta Coil Case Series and Literature Review

Vertebral artery course variation leading to an insufficient proximal anchoring area for thoracic endovascular aortic repair

Direct Vertebral Artery Access for Coil Embolization of a Partially Thrombosed Mid-Basilar Trunk Aneurysm: Technical Limitations

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