Abstract |
The treatment of dissecting aneurysms of the vertebral artery (VA) involving the posterior inferior cerebellar artery ( PICA) or presenting with hypoplasia of the contralateral VA is controversial. We describe our experience with 4 ruptured and 2 unruptured VA dissecting aneurysms and discuss the efficacy of endovascular surgery using stents. All patients were male; their mean age was 50.7 years. According to World Federation of Neurological Surgeons (WFNS) grading, 3 of the ruptured aneurysms were grade V, the other was grade I. All patients were successfully treated using stents; in 5 we also coil-embolized the aneurysmal lumen. One aneurysm was treated by the placement of 2 stents covering the dissection site; there was a danger of aneurysmal rupture during coil embolization. No technical complications were encountered although one patient suffered minor rebleeding 5 days post-treatment. Delayed vasospasm occurred in 4 cases. According to the Glasgow Outcome Scale (GOS), at 3 months after treatment 2 patients had made a good recovery, one was moderately disabled, one suffered severe disability, and 2 had died. One death each was due to acute myocardial and brain stem infarction. Endovascular surgery using stents may be a useful treatment in patients in poor condition who manifest dissecting VA aneurysms involving the PICA or hypoplasia of the contralateral VA, especially in the acute period after rupture.
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Authors | S Suzuki, A Kurata, K Iwamoto, K Sato, J Niki, T Miyazaki, M Yamada, H Oka, K Fujii, S Kan |
Journal | Minimally invasive neurosurgery : MIN
(Minim Invasive Neurosurg)
Vol. 51
Issue 4
Pg. 193-8
(Aug 2008)
ISSN: 0946-7211 [Print] Germany |
PMID | 18683108
(Publication Type: Case Reports, Journal Article)
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Topics |
- Adult
- Aged
- Brain Stem
(blood supply, diagnostic imaging, pathology)
- Brain Stem Infarctions
(epidemiology)
- Cerebral Angiography
- Embolization, Therapeutic
(adverse effects, instrumentation, methods)
- Fatal Outcome
- Glasgow Outcome Scale
- Headache
(etiology, pathology, physiopathology)
- Humans
- Intracranial Aneurysm
(diagnostic imaging, pathology, surgery)
- Male
- Middle Aged
- Postoperative Complications
(epidemiology)
- Prostheses and Implants
(adverse effects, statistics & numerical data)
- Retrospective Studies
- Stents
(adverse effects, statistics & numerical data)
- Tomography, X-Ray Computed
- Treatment Outcome
- Unconsciousness
(etiology, pathology, physiopathology)
- Vascular Surgical Procedures
(adverse effects, instrumentation, methods)
- Vasospasm, Intracranial
(epidemiology)
- Vertebral Artery
(diagnostic imaging, pathology, surgery)
- Vertebral Artery Dissection
(diagnostic imaging, pathology, surgery)
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