Endovascular Treatment of Symptomatic Vertebral Artery Dissecting Aneurysms

Abstract

ObjectiveVertebral artery dissecting aneurysms (VADAs) are rare and many debates are present about treatment options. We review types and efficacy of our endovascular treatments and establish a safe endovascular therapeutic strategy regard to the angio-architecture of VADAs.Materials and MethodsBetween July 2008 and October 2015, we treated 22 patients with symptomatic VADAs. Fifteen patients presented with subarachnoid hemorrhage from the ruptured VADAs, digital subtraction angiography and magnetic resonance image confirmed the diagnosis and endovascular treatments were followed as their angio-architecture.ResultsClinical results were good in 13 patients (86.7%), and there were no technical problems during endovascular procedures. The other 2 patients with poor prognosis showed severe neurological deficits at the initial evaluation. Among the three different endovascular treatments, there were no radiologic cure in one patient with stent insertion alone, but the patient had no significant clinical symptoms either.ConclusionEndovascular treatments are safe and effective treatment option for managing VADAs and can be the first treatment of choice for most patients. To select proper endovascular treatment according to the angio-architecture of VADAs can reduce the risk of the treatment.

Endovascular treatment of vertebral artery dissecting aneurysm: A single‑center experience

“…However, it may be difficult to perform surgical treatment due to a deep location, adjacent brain stem and posterior cranial nerves. Endovascular embolization is the preferred strategy for VADA due to its safety and efficiency, which includes reconstruction and destruction techniques (1,14). Destruction technique refers to parent artery occlusion.…”