Endovascular Treatment of Symptomatic Intradural Vertebral Dissecting Aneurysms

Peluso, J.P.; Rooij, W.J. van; Sluzewski, M.; Beute, Guus; Majoie, C.B.

doi:10.3174/ajnr.a0771

Cited by 88 publications

(84 citation statements)

References 22 publications

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“…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].…”

Section: Discussionmentioning

confidence: 99%

“…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.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2012

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2 Abstract PurposePrevious reports have suggested that endovascular parent artery occlusion is an effective and safe procedure for the treatment of vertebral artery dissection (VAD). However, the results of long-term outcomes are still unclear. This study reviewed the clinical and imaging outcomes of patients with VAD treated by endovascular internal trapping. MethodsA total of 73 patients were treated for VAD by endovascular internal trapping between March 1998 and March 2011. Patients were regularly followed up by magnetic resonance imaging, magnetic resonance angiography, and clinical examinations. Clinical outcomes were evaluated using the modified Rankin Scale. ResultsForty-five patients had ruptured VADs, and 28 had unruptured VADs. Clinical follow-up of at least 6 months data were obtained for 61 patients (83.6%). The follow-up period ranged from 6 to 145 months (mean ± SD, 55.6 ± 8.9 months). Two patients with ruptured VADs had recurrence (2.74%). Cranial nerve paresis (CNP) was observed in 6 patients (8.21%), spinal cord infarction in 2 patients(2.74%) and a perforating artery ischemia was diagnosed in 7 patients (9.59%); all patients with CNP and 5 of the patients with partial Wallenberg syndrome experienced only temporary symptoms; 2 of the patients with partial Wallenberg syndrome had permanent neurological deficits. Despite their symptoms, most patients were in good general condition, as shown by their clinical scores. ConclusionsThe results of this study have proven that endovascular internal trapping is a stable and durable treatment for closure of VADs. Recanalization is rather rare and occurred only in ruptured cases., both within 3months after tnitial treatment without rupture. CNP were observed in 8.21%, perforating ischemia in 9.59%, and spinal cord infarction in 2.74%. The former two are temporaly, while the last can be a factor that affect mRS. Patients rated their quality of life as good, as corroborated by their posttreatment clinical score. Endovascular internal trapping for VAD is a therapy with a satisfactory long-term outcome.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2012

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“…In this way, the whole vertebral segment including the aneurysm is occluded with coils. 19 The contralateral vertebral artery will provide flow to the basilar artery, and the ipsilateral vertebral artery supplies the PICA. Only in patients with a single vertebral artery without patent posterior communicating arteries, is sparing the parent vessel mandatory.…”

Section: Vertebral Artery Occlusionmentioning

confidence: 99%

Endovascular Treatment of Large and Giant Aneurysms

Rooij¹,

Sluzewski²

2008

AJNR Am J Neuroradiol

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111

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SUMMARY:Very large and giant (Ն15 mm) cerebral aneurysms have a poor natural history, with high risk of subarachnoid hemorrhage or progressive symptoms of mass effect. Several endovascular techniques may be applied for treatment, depending on location, size, anatomy and presence of collateral circulation. The authors reviewed their clinical experience in endovascular treatment of 232 very large and giant aneurysms and present their perspective on the present state of the art in endovascular therapy for these aneurysms.

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“…Most ruptured VBDAs can be treated by deconstructive treatments, which sacrifice the parent artery to obliterate the dissecting aneurysm. [1][2][3][4] However, how to manage a ruptured VBDA, which is not suitable for deconstructive treatment, is not well established. Also, there has been controversy on how to manage an unruptured VBDA.…”

mentioning

confidence: 99%

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

Park

Kim²,

Kim

et al. 2009

AJNR Am J Neuroradiol

116

103

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Endovascular Treatment of Symptomatic Intradural Vertebral Dissecting Aneurysms

Abstract: BACKGROUND AND PURPOSE:The purpose of this study was to report our experience with endovascular treatment of 14 patients with symptomatic intradural vertebral dissecting aneurysms.

Cited by 88 publications

References 22 publications

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

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

Endovascular Treatment of Large and Giant Aneurysms

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

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