Application of covered stent grafts for intracranial vertebral artery dissecting aneurysms

He, Min; Zhang, Heng; Ding, Lei; Mao, Biming; You, Chao; Xie, Xiaohua; Sun, Hong; Jiang, Yan; Zhang, Jiaming

doi:10.3171/2008.3.17470

Cited by 22 publications

(21 citation statements)

References 35 publications

(22 reference statements)

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“…Various endovascular methods have been used to treat the VBDA, which include proximal occlusion of the parent artery, internal coil obliteration or trapping of the dissected segment of the parent artery, stent-assisted coiling, stent-only therapy with single or multiple stents, and covered stent. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] However, for the VBDA not suitable for deconstructive treatments that occludes the parent artery, the appropriate treatment method has not been well established. In patients who had basilar dissecting aneurysms or dominant vertebral dissecting aneurysms with poor collaterals, internal coil trapping cannot be applied.…”

Section: Discussionmentioning

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

114

101

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Section: Discussionmentioning

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

114

101

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“…4,6,7,[9][10][11]18,[23][24][25]29) Internal trapping of the parent artery is considered to be the best treatment for VA dissecting aneurysm if the collateral blood flow is sufficient to allow sacrifice of the parent vessel without neurological deficit. 7,9,20,23,29) In the present case, we believed that emergent endovascular treatment was not applicable because of the patient's poor condition.…”

Section: Discussionmentioning

confidence: 99%

“…1,13,26,27) Most dissections rebleed during the acute phase, 1,13,26,27) so emergent surgical internal trapping of the parent artery is recommended. 4,6,7,[9][10][11]20,23,29) However, the rate of rebleeding decreases during the chronic stage because of the spontaneous resolution of the dissecting walls of the VA. 14,15,19) Antegrade recanalization in the parent artery occasionally occurs after internal trapping. 2,8,12,22,29) However, additional treatment for recanalized dissecting lesions may be unnecessary during the chronic stage because of spontaneous resolution of the affected vessels during the chronic stage.…”

Section: Introductionmentioning

confidence: 99%

Long-Term Follow Up of Antegrade Recanalization of Vertebral Artery Dissecting Aneurysm After Internal Trapping -Case Report-

Kojima

Okui

Onozuka

2010

Neurol. Med. Chir.(Tokyo)

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A 34-year-old female presented with subarachnoid hemorrhage caused by the rupture of a right vertebral artery (VA) dissecting aneurysm. The affected site, including the aneurysm and parent artery, was successfully occluded with detachable coils. Follow-up angiography performed 28 days after the endovascular treatment revealed recanalization of the parent artery. We decided to treat the patient conservatively without further intervention because the aneurysm had been completely occluded. Magnetic resonance imaging showed a normal VA configuration with a minor irregularity of the affected wall at 6 years after onset. Rebleeding tends to occur during the acute stage because spontaneous healing of the dissecting vascular wall typically occurs within one month after onset. Our case suggests that additional intervention is unnecessary during the chronic stage once the aneurysm has been occluded and no further signs of the development of VA dissection are found.

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“…Various endovascular strategies have been proposed to treat ruptured vertebra-basilar artery dissecting aneurysms, including proximal parent vessel occlusion, internal coil trapping, stent-assisted coil embolization, stent-only therapy (multiple overlapping stents, double or triple stents), covered stent placement, and a stent-within-a-stent technique [1,2,4,7,8,12,20,22,25,28,31,32,38]. Internal coil trapping of the dissected segment has been considered one of the most reliable methods for preventing rebleeding.…”

Section: Discussionmentioning

confidence: 99%

Endovascular treatment of basilar artery trunk aneurysms

et al. 2011

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Background There has been little reported on the endovascular experience of basilar artery (BA) trunk aneurysms due to its low incidence. The purpose of this study is to report the results of endovascular treatment (EVT) of BA trunk aneurysms. Methods Between 2004 and 2008, eight BA trunk aneurysms were treated by EVT. Five patients presented with subarachnoid hemorrhage, one had intracranial mass effect, and in two of the patients the aneurysms were found incidentally. Four lesions were saccular aneurysms, three of them were found with BA fenestration. Three lesions were dissecting aneurysms and one was a giant fusiform aneurysm. The mean follow-up period of clinical outcome was 17.1 months (range, 6-32 months). Angiographic follow-up data was obtained in six patients for period of a mean of 15.6 months (range, 6-25 months). Results Four patients with saccular aneurysms were treated by stent-assisted coil embolization except for one patient that was treated without a stent. Three patients with dissecting aneurysms were treated by a single stent placement. One of these dissecting aneurysms rebled in 4 days after stent placement and was secured by BA occlusion. One giant fusiform aneurysm was treated by bilateral vertebral artery (VA) occlusion after balloon test occlusion. Six patients (75.0%) had excellent or good clinical outcomes, one patient whose aneurysm rebled became vegetative, and one patient with bilateral VA occlusion died. Follow-up angiograms showed that four lesions had complete occlusion and two had neck remnant. Conclusions The endovascular catheterization of these lesions tends to be relatively simple compared to more complex neurosurgical approaches. EVT, especially using a stent, could be a valuable therapeutic method in treating BA trunk aneurysms.

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Application of covered stent grafts for intracranial vertebral artery dissecting aneurysms

Cited by 22 publications

References 35 publications

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

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

Long-Term Follow Up of Antegrade Recanalization of Vertebral Artery Dissecting Aneurysm After Internal Trapping -Case Report-

Endovascular treatment of basilar artery trunk aneurysms

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