Objective Intracranial spontaneous vertebral artery
dissecting aneurysms commonly occur in the third to fifth decades of life, and are mostly associated with
hypertension. Patients present with intracranial haemorrhage or thromboembolic events. Patients who present with intracranial haemorrhage carry about a 70% risk of recurrent
bleeding. Patients with a posterior-inferior cerebellar artery (
PICA) or ipsilateral dominant vertebral artery involve selecting which parent vessel could not be sacrificed. Recent reconstructive techniques such as
stent-assisted coiling embolisation and flow-diverting
stents are effective treatments of choice. Methods Seventeen patients presented subarachnoid haemorrhage and nine patients with other symptoms. Sacrificing the parent vertebral artery was the first choice for surgical or endovascular methods. Endovascular reconstructive treatment by
stent-assisted coiling embolisation was indicated in dissecting vertebral artery
aneurysms with ipsilateral dominant vertebral artery or
PICA involvement. Clinical outcomes were determined using the modified Rankin Score (mRS) at 90 days, with favourable outcomes defined as 0 to 2. Results Of the patients presenting with
ruptured aneurysms, 11 (61.1%) had a good clinical outcome, with a mRS of 0-2. Favourable Hunt and Hess grading (65%), mild to moderate GCS (65%) and total occlusion of
aneurysms after treatment (65%) were significantly good prognostic factors in patients with ruptured vertebral artery
dissecting aneurysms. Conclusion Endovascular parent vessel sacrifice could be the first choice to treat a ruptured vertebral artery
dissecting aneurysm.
Stent-assisted coiling to preserve the patency of the parent artery and its branches is a promising treatment for
vertebral artery dissections.