Incidence of Ischemic Complications after Endovascular Treatment for Ruptured Dissecting Vertebral Artery Aneurysms

Abstract

We analyzed the incidence of ischemic complications after internal trapping for ruptured VA dissecting aneurysms.

Between April 2001 and August 2005, nine cases of ruptured VA dissecting aneurysms, five in women, “proximal” or distal (distal type) to the origin of the PICA, were treated by internal trapping in the acute stage after SAH. There were four cases of proximal type and five of distal type. The demographics of the patients were reviewed in the medical charts and radiological findings were evaluated by neuroradiologists. The dissected site was completely obliterated and PICA was preserved in all cases. Follow-up angiography performed five to 19 days after treatment revealed complete obliteration of the aneurysm and patency of the PICA. The incidence of perioprocedural ischemic complications for the PICA-distal type (75%) was higher than that for the PICA-proximal type (20%).

Here we retrospectively analyzed and discussed the incidence and mechanisms of ischemic complications.

Keywords

dissecting vertebral aneurysm ischemic complications

Get full access to this article

View all access options for this article.

References

Aoki

Sakai

: Rebleeding from intracranial dissecting aneurysm in the vertebral artery. Stroke 21: 1628–1631, 1990.

Iihara

Sakai

: Dissecting aneurysms of the vertebral artery: A management strategy. J Neurosurg 97: 259–267, 2002.

Kitanaka

Sasaki

: Intracranial vertebral artery dissections: Clinical, radiological features, and surgical considerations. Neurosurgery 34: 620–626; discussion 626–627, 1994.

Kurata

Ohmomo

: Coil embolization for the treatment of ruptured dissecting vertebral aneurysms. Am J Neuroradiol 22: 11–18, 2001.

Lylyk

Cohen

: Combined endovascular treatment of dissecting vertebral artery aneurysms by using stents and coils. J Neurosurg 94: 427–432, 2001.

Manabe

Hatayama

: Coil embolisation for ruptured vertebral artery dissection distal to the origin of the posterior inferior cerebellar artery. Neuroradiology 42: 384–387, 2000.

Mizutani

Aruga

: Recurrent subarachnoid hemorrhage from untreated ruptured vertebrobasilar dissecting aneurysms. Neurosurgery 36: 905–911; discussion 912–903, 1995.

Yamaura

Tani

: Endovascular treatment of ruptured dissecting aneurysms aimed at occlusion of the dissected site by using Guglielmi detachable coils. J Neurosurg 90: 853–856, 1999.