Long-term follow-up study of unruptured vertebral artery dissection: clinical outcomes and serial angiographic findings

Abstract

A follow-up angiography study must be performed during the early stage (within approximately 3 weeks after onset of symptoms) to confirm the formation or enlargement of an aneurysm, because such conditions may be amenable to surgical treatment. Unruptured VA dissection could otherwise be treated and followed conservatively. Although the majority of dissected lesions seem likely to stabilize within a few months, as evidenced on angiography, in some cases a longer observation period is required.

Endovascular coil oclusion of spontaneous ruptured vertebral artery dissecting aneurysm

“…Continuous hemodynamic stress on this thin layer of intradural adventitia will result in a subarachnoid hemorrhage. The reported incidence of SAH in the literature was between 67% and 86% [7,8].…”

“…The firs surgical procedure consisting in proximal occlusion of the vertebral artery close to dissection was reported by Yonas et all in 1977. For about a decade this procedure was considered as standard surgical technique for this vascular condition [ 5,6,7,8]. Thus, the strategy of endovascular treatment changed from proximal occlusion to trapping by complete occlusion of arterial dissection segment with detachable coils.…”

“…For lesion involving the origin of PICA or spinal artery Iiahara et all [5,6] reported a therapeutic planning to minimize the risk of treatement-releated morbidity based on balloon test occlusion followed by internal trapping of the dissected site [7,8,9,10].…”

Vertebral Artery Dissection with a Normal-Appearing Lumen at Multisection CT Angiography: The Importance of Identifying Wall Hematoma

“…1 This can demonstrate the typical angiographic findings of an intimal flap: irregularity and/or stenosis of the vessel, the string sign (arising as a result of a dissection that extends circumferentially around the lumen over a long segment), the double lumen sign, pseudoaneurysm formation, or complete occlusion. [2][3][4] Stenosis is by far the most common finding resulting in luminal narrowing by subintimal hematoma formation. 4 In our center and many others, noninvasive imaging for suspected dissections has complemented or even replaced conventional angiography.…”

“…[2][3][4] Stenosis is by far the most common finding resulting in luminal narrowing by subintimal hematoma formation. 4 In our center and many others, noninvasive imaging for suspected dissections has complemented or even replaced conventional angiography. This may consist of MR imaging, MR angiography (MRA), and/or multisection helical CT angiography.…”