Endovascular treatment of ruptured dissecting vertebral artery aneurysms—long-term follow-up results, benefits of early embolization, and predictors of outcome

Abstract

In our experience, internal trapping of the dissected segment with a coil was straightforward, applicable to most patients, prevented rebleeding safely and effectively without significant procedural complications, and had a good follow-up outcome. The low Hunt-Hess grade remained predictors of favorable clinical outcomes. The timing of embolization did not significantly affect clinical outcome but early embolization reduces inpatient stay.

Long-term clinical and radiological results of endovascular internal trapping in vertebral artery dissection

“…During the past 10 years, there have been a significant number of investigations into the feasibility of this technique [1][2][3][4][5][6][7][8][9][10]. Some articles have described the stability of occlusions treated with detachable coils and the efficacy of providing protection against VAD recurrence and consequent bleeding [4,5].…”

“…Conventional surgical treatment includes trapping the aneurysm, proximal ligation of the vertebral artery (VA ), or wrapping the aneurysm. Previous reports have suggested that endovascular parent artery occlusion is a safe and effective treatment for VAD [1][2][3][4][5][6][7][8][9][10]. Although some case series have reported on the feasibility of stent replacement, endovascular internal trapping has been performed in most of the cases.…”

“…Although some case series have reported on the feasibility of stent replacement, endovascular internal trapping has been performed in most of the cases. However, few reports have been published on this subject, leaving the status of long-term outcomes unclear [4,5]. This study reviewed the long-term clinical and imaging outcomes of patients with VAD who were treated by endovascular parent artery internal trapping.…”

Long-Term Clinical and Imaging Follow-Up of Complex Intracranial Aneurysms Treated by Endovascular Parent Vessel Occlusion

“…These results are in keeping with the published results of others. [24][25][26][27][28][29] A single patient in our series demonstrated immediate persistent filling of the ruptured pseudoaneurysm after proximal PVO. Importantly, the dissected vessel segment involved the origin of the PICA.…”

The Strategy of Endovascular Treatment for Ruptured Vertebral Artery Dissecting Aneurysm, Based on Its Location Relating to the Position of the Posterior Inferior Cerebellar Artery Origin

“…[1][2][3][4][5][6][7] Although there have been recent reports documenting the effectiveness of stent-assisted coil embolization or flow diverter stent placement, [8][9][10] but parent artery occlusion remains as a safe and effective treatment, particularly in the acute phase of rupture. 11,12) To minimize the risk of re-hemorrhage and developing cerebral infarction following parent artery occlusion, it is important to make a strategy based on the location of the lesion relating to the posterior inferior cerebellar artery (PICA) origin.…”