Endovascular treatment for large and giant fusiform aneurysms of the vertebrobasilar arteries

Chen, Zhi; Yang, Yuan; Miao, Hongpin; Tang, Weihua; Chen, Jingyu; Yin, Ning; Feng, Hua; Zhu, Gang

doi:10.1016/j.clinimag.2012.05.002

Cited by 13 publications

(10 citation statements)

References 20 publications

(34 reference statements)

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“…The classical treatment of choice for dissecting aneurysms remains trapping or parent artery occlusion with a success rate of 62-73% [18][19][20] . However, in the setting when there is insufficient collateral flow or major branches such as involvement of the posterior inferior cerebellar artery, parent vessel preservation is paramount.…”

Section: Resultsmentioning

confidence: 99%

Use of the Pipeline Embolization Device to Treat Recently Ruptured Dissecting Cerebral Aneurysms

et al. 2014

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The Pipeline embolization device (PED) is one of the flow-diverting stents approved for the treatment of unruptured large or wide-necked cerebral aneurysms in 2011. Its use has now been extended to the treatment of recently ruptured dissecting cerebral aneurysm, carotid pseudoaneurysm from radiation injury, and blister aneurysms. We aimed to evaluate the effectiveness of utilizing the PED as a primary treatment for ruptured dissecting intracranial aneurysms. A single center retrospective review was conducted for all patients primarily treated with PED for acute subarachnoid hemorrhage (SAH) from ruptured dissecting cerebral aneurysms between December 2010 and February 2013. Patients were followed up with CT angiogram (CTA) or digital subtraction angiogram (DSA). Eight patients with a total of eight dissecting aneurysms were identified. The mean duration from SAH to treatment was 2.5 days. Six of the aneurysms arose from vertebral arteries and two from the basilar artery. Immediate check-DSA confirmed satisfactory contrast stasis in all eight cases, and complete aneurysmal obliteration was achieved at six months. There were two (25%) procedure-related complications, but no major procedure-related complications, such as thromboembolic events or rebleeding from aneurysm were encountered. The PED is a feasible treatment option for ruptured dissecting cerebral aneurysms in acute phase. According to our experience, using PED as flow-diverters in acute SAH does not significantly increase the complication risks or mortality rate if the antiplatelet regime is carefully monitored. Future studies shall evaluate the optimal antiplatelet regimen for using the PED in the acute phase.

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Section: Resultsmentioning

confidence: 99%

Use of the Pipeline Embolization Device to Treat Recently Ruptured Dissecting Cerebral Aneurysms

et al. 2014

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“…Chen et al . 74 reported a series of 10 consecutive cases with large and giant fusiform aneurysms. Five patients had sole stent placement, three patients underwent stent-assisted coiling, and two patients sacrificed the parent arteries with coils at the proximal of vertebral artery.…”

Section: Treatment Strategiesmentioning

confidence: 99%

Research Progress on Vertebrobasilar Dolichoectasia

Yuan¹,

Xu²,

Luo³

et al. 2014

Int. J. Med. Sci.

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Vertebrobasilar dolichoectasia (VBD) is a rare disease characterized by significant expansion, elongation, and tortuosity of the vertebrobasilar arteries. Current data regarding VBD are very limited. Here we systematically review VBD incidence, etiology, characteristics, clinical manifestations, treatment strategies, and prognosis. The exact incidence rate of VBD remains unclear, but is estimated to be 1.3% of the population. The occurrence of VBD is thought to be due to the cooperation of multiple factors, including congenital factors, infections and immune status, and degenerative diseases. The VBD clinical manifestations are complex with ischemic stroke as the most common, followed by progressive compression of cranial nerves and the brain stem, cerebral hemorrhage, and hydrocephalus. Treatment of VBD remains difficult. Currently, there are no precise and effective treatments, and available treatments mainly target the complications of VBD. With the development of stent technology, however, it may become an effective treatment for VBD.

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“…Some clinical reports have shown the progression of VBD despite occluding both vertebral arteries [ 40 ]. Finally, the use of flow-diverting stents [ 41 , 42 ], or overlapping stent or coil-assisted stent reconstruction have been recently reported, with varying degrees of success [ 43 , 44 ]. All of these invasive treatment approaches require experienced neurosurgical operators because of the inherent risk of brain stem stroke [ 45 ].…”

Section: Discussionmentioning

confidence: 99%

Acute Bilateral Ophthalmoplegia Due to Vertebrobasilar Dolichoectasia: A Report of Two Cases

et al. 2017

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Case seriesPatient: Male, 52 • Female, 68Final Diagnosis: VBDSymptoms: OphthalmoplegiaMedication: —Clinical Procedure: —Specialty: NeurologyObjective:Unusual clinical courseBackground:Vertebrobasilar dolichoectasia (VBD) is a complex progressive arterial disease characterized by dilation, elongation, and tortuosity of the vertebral and basilar arteries, and may be congenital or acquired. VBD may lead to progressive compression of the brainstem, cranial nerve abnormalities, and intracranial hemorrhage, but may also be associated with arterial thrombosis, with ischemic stroke as the most common clinical outcome.Case Report:Two cases of VBD are presented, both with acute bilateral ophthalmoplegia and cranial nerve palsies, and vertebrobasilar arterial thrombosis that resulted in ischemic stroke.Conclusions:VBD is a complex arterial disease with a variety of clinical manifestation, with bilateral ophthalmoplegia being a rare presentation. Clinical management of VBD is a challenge as there are no current management guidelines. Therefore, clinical management of cases of VBD should be individualized to balance the risks and benefits of treatment options for each patient.

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Endovascular treatment for large and giant fusiform aneurysms of the vertebrobasilar arteries

Cited by 13 publications

References 20 publications

Use of the Pipeline Embolization Device to Treat Recently Ruptured Dissecting Cerebral Aneurysms

Use of the Pipeline Embolization Device to Treat Recently Ruptured Dissecting Cerebral Aneurysms

Research Progress on Vertebrobasilar Dolichoectasia

Acute Bilateral Ophthalmoplegia Due to Vertebrobasilar Dolichoectasia: A Report of Two Cases

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