Strategy for Treating Unruptured Vertebral Artery Dissecting Aneurysms

Abstract

The nature of an unruptured VADA is not highly aggressive. However, if the dissection site enlarges without the manifestation of new symptoms, it should be occluded. In patients with recurrent ischemic attacks antiplatelet therapy should be considered.

Deconstructive and Reconstructive Techniques in Treatment of Vertebrobasilar Dissecting Aneurysms: A Systematic Review and Meta-Analysis

“…12 Reconstruction of PICA-involving lesions often requires the aneurysm sac to be left partially open to ensure adequate PICA flow. 18 This places the patient at a high risk of recanalization, which, in the setting of ruptured VBDA, can result in hemorrhage. Thus, for these types of lesions, bypass surgery should be considered.…”

Surpass Flow Diverter for Treatment of Posterior Circulation Aneurysms

“…There is some evidence that acute intervention is not always required, and close follow-up with antithrombotic therapy is a reasonable option. [11][12][13] Yet, we lack greater knowledge on the clinical course of these potentially benign vascular lesions; this issue complicates any meaningful risk-benefit analysis of FD treatment in this clinical setting. The high morbidity and mortality rates in our series were related to the treatment of patients with symptomatic type 3 aneurysms.…”

Natural Course of Dissecting Vertebrobasilar Artery Aneurysms without Stroke

“…At the same time, the natural history of nonstroke DVBA is unknown. 1,2 Furthermore, the risks and benefits of antiplatelet or anticoagulation therapy for nonstroke DVBA are unclear. The aim of this study was to evaluate the natural course of nonstroke DVBA by identifying the factors associated with clinical and morphologic deterioration and thus contributing to the optimal management strategy.…”