Treatment of a dissecting vertebral artery aneurysm with angioplasty and the pipeline embolisation device

Shah, Veer; Leonard, Patrik; Sessions, Jordan; Holloway, W

doi:10.1136/bcr-2015-210485

Cited by 2 publications

(3 citation statements)

References 14 publications

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“…37,38 In patients who are resistant to medical management, the AHA gives only a class IIb recommendation for angioplasty and/or stenting, 38 though there are many reports of strong outcomes. [39][40][41][42][43][44][45][46] For patients with intracranial artery dissection and ischemic events, there is little data indicating best practices, though these patients are most often treated with antiplatelet medication. 47 Outcomes in patients with VAD are largely dependent on the severity of the associated stroke.…”

Section: Discussionmentioning

confidence: 99%

“…Accordingly, based on CADISS trial, the American Heart Association (AHA) recommends treatment with either antiplatelets or anticoagulants for 3 to 6 months in individuals with extracranial cervical artery dissection (class IIa) 37,38. In patients who are resistant to medical management, the AHA gives only a class IIb recommendation for angioplasty and/or stenting,38 though there are many reports of strong outcomes 39–46. For patients with intracranial artery dissection and ischemic events, there is little data indicating best practices, though these patients are most often treated with antiplatelet medication 47…”

Section: Discussionmentioning

confidence: 99%

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Vertebral Artery Dissection in a Woman Due to Golf

Gallaer

Archambault²,

Patel³

et al. 2021

The Neurologist

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Introduction: Traditionally, spontaneous cervical artery dissections have been associated with violent, sudden neck movements. These events are a significant cause of stroke related morbidity, particularly in young people. Only a handful of cases of golf-induced vertebral artery dissection (VAD) have been described, and the discussion has primarily focused on middle-aged men. Despite the discussion focused on this demographic, women are participating in golf at higher rates than ever before, and have a higher risk for developing VAD. Case Report: A 41-year-old woman presented to our hospital with sharp neck pain, dizziness, and ptosis after swinging a driver during a morning round of golf. Imaging demonstrated a right V3/V4 VAD and subsequent ischemic infarction. After administration of tissue plasminogen activator she had abrupt change in mental status with seizure-like activity. She underwent angiogram and mechanical thrombectomy, and was started in heparin 24 hours post-tissue plasminogen activator. This was subsequently changed to low-dose aspirin following thalamic petechial hemorrhage. She was discharged from the hospital after a few days with only minor deficits. We will discuss mechanism, treatment, and outcomes of VAD in context of this case. Conclusion: This patient is the first woman in the literature to suffer from VAD as a result of playing golf. The twisting motion of the head and neck in a golf swing may be a risk factor for dissection and subsequent development of stroke. As a result of increased female participation in golf, we expect to see increased incidence of women presenting with “golfer’s stroke” in coming years.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Vertebral Artery Dissection in a Woman Due to Golf

Gallaer

Archambault²,

Patel³

et al. 2021

The Neurologist

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“…Vertebral artery dissecting aneurysm (VADA) is a rare and special vascular disease characterized by a dilation of the wall of an artery resulting from tears in the intima and elastic lamina (1). Although VADA is not one of the most commonly encountered intracranial aneurysms, it can cause high mortality and morbidity if ruptures (2).…”

Section: Introductionmentioning

confidence: 99%

Flow diverters in the treatment of unruptured vertebral artery dissecting aneurysm: A single-center experience

Lu¹,

Zhang²,

Zhou³

et al. 2023

Front. Neurol.

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ObjectiveTo evaluate the efficacy and safety of flow diverters (FD) in the treatment of vertebral artery dissecting aneurysm (VADA).MethodsA total of 16 patients with 17 unruptured VADAs treated with FD from January 2017 to May 2021 were included. Data of clinical outcomes and radiographic examination were collected and assessed by the modified Rankin Scale (mRS) and O'Kelly-Marotta (OKM) grading scale.ResultsAll patients were treated with a single FD. No perioperative complications occurred. The mean age was 55.1 years old. The mean size of the aneurysm was 10.4 mm. All patients had a favorable occlusion (OKM D + C3) result and the complete occlusion rate in the 6th month was 66.7% (OKM D). The mean clinical follow-up time was 7.8 months, and all patients had a good clinical outcome (mRS = 0). No procedure-related complication occurred at the last follow-up time.ConclusionFD is an effective and safe tool for treating unruptured VADA. Long-term prospective studies with a large sample are still needed to confirm these findings in the future.

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Treatment of a dissecting vertebral artery aneurysm with angioplasty and the pipeline embolisation device

Cited by 2 publications

References 14 publications

Vertebral Artery Dissection in a Woman Due to Golf

Vertebral Artery Dissection in a Woman Due to Golf

Flow diverters in the treatment of unruptured vertebral artery dissecting aneurysm: A single-center experience

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