The Difference of Each Angiographic Finding After Multiple Stent According to Stent Type in Bilateral Vertebral Artery Dissection

Lee, Dong Hoon; Yoon, Woon Ki; Baik, Min Woo; Kim, Hoon

doi:10.7461/jcen.2013.15.3.229

Cited by 6 publications

(3 citation statements)

References 23 publications

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“…However, it is essential to identify the true lumen from the pseudolumen before stenting, which could be challenging under circumstances. 72 Open surgery is seldom used to treat intracranial dissecting aneurysms; however, Wu and Chin in 2013 reported a rare case of a large dissecting aneurysm in A1 segment of ACA, where surgical option was selected in order to treat the aneurysm and to eliminate the mass effect. 73 …”

Section: Transluminal Embolization Techniquesmentioning

confidence: 99%

Current Treatment Strategies for Intracranial Aneurysms: An Overview

Lin²,

et al. 2017

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Intracranial aneurysm is a leading cause of stroke. Its treatment has evolved over the past 2 decades. This review summarizes the treatment strategies for intracranial aneurysms from 3 different perspectives: open surgery approach, transluminal treatment approach, and new technologies being used or trialed. We introduce most of the available treatment techniques in detail, including contralateral clipping, wrapping and clipping, double catheters assisting coiling and waffle-cone technique, and so on. Data from major trials such as Analysis of Treatment by Endovascular approach of Non-ruptured Aneurysms (ATENA), Internal Subarachnoid Trial (ISAT), Clinical and Anatomical Results in the Treatment of Ruptured Intracranial Aneurysms (CLARITY), and Barrow Ruptured Aneurysm Trial (BRAT) as well as information from other clinical reports and local experience are reviewed to suggest a clinical pathway for treating different types of intracranial aneurysms. It will be a valuable supplement to the current existing guidelines. We hope it could help assisting real-time decision-making in clinical practices and also encourage advancements in managing the disease.

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Section: Transluminal Embolization Techniquesmentioning

confidence: 99%

Current Treatment Strategies for Intracranial Aneurysms: An Overview

Lin²,

et al. 2017

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“…These intracranial stents are not specifically designed to alter intra-aneurysmal hemodynamics. It is also difficult to navigate the tortuous vessels by using balloon expandable stents [21] . Newly developed flow diverters including Pipeline embolization device (PED) (Covidien/ev3 Irvine, CA, USA), SILK (BALT Extrusion, France) and the new Flow Re-direction Endoluminal Device FRED (MicroVention Inc. Tustin, CA, USA) devices, which have far less porosity than conventional neurovascular stents, may play a role in reconstructive treatment of intracranial dissecting aneurysms, by demonstrating favorable long-term clinical and angiographic outcomes with the ability to maintain parent artery and side-branch patency.…”

Section: Discussionmentioning

confidence: 99%

Retreatment and Outcomes of Recurrent Intracranial Vertebral Artery Dissecting Aneurysms after Stent Assisted Coiling: A Single Center Experience

Song

Wang

et al. 2014

PLoS ONE

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Background and purposeThe retreatment of recurrent intracranial vertebral artery dissecting aneurysms (VADAs) after stent assisted coiling (SAC) has not yet been studied. The purpose of this study was to evaluate the strategies and outcomes for retreatment of recurrent VADAs after SAC.MethodsBetween September 2009 and November 2013, six consecutive patients presenting with recurrent intracranial VADAs after SAC were enrolled in this study. They were all male with age ranging from 29 to 54 years (mean age, 46.2 years). The procedures of treatments and angiographic and clinical follow-up were reviewed retrospectively. Retreatment modalities were selected individually according to the characteristics of recurrence. The outcomes of retreatment were evaluated by angiographic and clinical follow-up.ResultsSix patients with recurrent intracranial VADAs after SAC were retreated, with second SAC in three patients, coil embolization, double overlapping stents placement and endovascular occlusion with aneurysm trapping in one patient, respectively. Immediate angiographic outcomes of retreatment were: complete occlusion in three patients, nearly complete occlusion in two patients, and contrast medium retention in dissecting aneurysm in one patient. All cases were technically successful. No complications related to endovascular procedures occurred. Angiographic follow-up was available in all five patients treated with second SAC or double overlapping stents, which was complete occlusion in four patients, obliteration of parent artery in one patient, showing no recurrence at 4–11 months (mean: 8.6 months). Clinical follow-up was performed in all six patients at 11–51 months after initial endovascular treatment and at 9–43 months after retreatment. The mRS of last clinical follow-up was excellent in five patients and mild disability in only one patient.ConclusionsEndovascular retreatment is feasible and effective for recurrent intracranial VADAs after SAC. Individualized strategies of retreatment should be enacted according to the characteristics and reasons for the recurrence.

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“…[2][3][4] Bilateral IVADAs account for less than 10% of all IVADAs, but their management is more complex and challenging. [5][6][7][8][9] Endovascular treatment has emerged as a major therapeutic option for IVADAs, with successful results reported for staged bilateral vertebral artery (VA) occlusion of bilateral IVADAs; 10 however, bilateral VA occlusion is not tolerated in many patients. Unilateral trapping or bilateral parent artery reconstructive therapy has been used to treat such intolerant patients.…”

Section: Introductionmentioning

confidence: 99%

Endovascular treatment of bilateral intracranial vertebral artery aneurysms: an algorithm based on a 10-year neurointerventional experience

et al. 2020

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BackgroundThe management of bilateral intracranial vertebral artery dissecting aneurysms (IVADAs) is controversial, and requires the development of endovascular treatment modalities and principles. We aim to investigate the endovascular treatment strategy and outcomes of bilateral IVADAs.MethodsWe identified all bilateral IVADAs at a high-volume neurointerventional centre over a 10-year period (from January 2009 to December 2018). Radiographic and clinical data were recorded, and a treatment algorithm was derived.ResultsTwenty-seven patients with bilateral IVADAs (54 IVADAs in total, 51 unruptured, 3 ruptured) were diagnosed. Four patients (14.8%) received single-stage endovascular treatment, 12 patients (44.4%) with staged endovascular treatment and 11 patients (40.8%) with unilateral endovascular treatment of bilateral IVADAs. Thirty-six IVADAs (85.7%) have complete obliteration at the follow-up angiography. Two of three ruptured IVADAs with stent-assisted coiling recanalised, and had further recoiling. Three patients (11.1%) have intraprocedural or postprocedural complications (two in single-stage and one in staged). Twenty-five patients (92.6%) had a favourable clinical outcome, and two patients (7.4%, all in single-stage) showed an unfavourable clinical outcome at follow-up. For the patients with unilateral reconstructive endovascular treatment, the contralateral untreated IVADAs were stable and had no growth or ruptured during follow-up period. None of all IVADAs had rebleeding during the clinical follow-up.ConclusionsEndovascular treatment can be performed in bilateral IVADAs with high technical success, high complete obliteration rates and acceptable morbidity/mortality. Contralateral IVADAs had low rates of aneurysm growth and haemorrhage when treated in a staged/delayed fashion.

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The Difference of Each Angiographic Finding After Multiple Stent According to Stent Type in Bilateral Vertebral Artery Dissection

Cited by 6 publications

References 23 publications

Current Treatment Strategies for Intracranial Aneurysms: An Overview

Current Treatment Strategies for Intracranial Aneurysms: An Overview

Retreatment and Outcomes of Recurrent Intracranial Vertebral Artery Dissecting Aneurysms after Stent Assisted Coiling: A Single Center Experience

Endovascular treatment of bilateral intracranial vertebral artery aneurysms: an algorithm based on a 10-year neurointerventional experience

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