title: Rebleeding of a vertebral artery dissecting aneurysm during stent-assisted coil embolization: a pitfall of the "stent and coil" technique.
abstract: BACKGROUND
  A stent-assisted coil embolization has been applied as a novel choice of treatment for vertebral artery dissecting aneurysms (VADAs).
  
  
  METHODS
  A 45-year-old man suffered from subarachnoid hemorrhage three times within 2 hours. The left vertebral angiogram showed a VADA at the distal origin of the posterior inferior cerebellar artery. The right vertebral artery was hypoplastic, and collateral circulation to the posterior fossa was poor.
  
  
  METHODS
  Stent-assisted coil embolization was performed under general anesthesia. The aneurysm was excluded from the circulation with good patency of the vertebral artery, although the fourth coil caused rebleeding from the aneurysmal dome during the procedure.
  
  
  CONCLUSIONS
  This is the first case report that demonstrates rebleeding from VADA during stent-assisted coil embolization in the acute stage of its rupture. We have to be aware of the risks and be ready to prevent fatal complications with this novel technique.
authors.affiliation: Department of Neurological Surgery, Okayama University Medical School, Okayama, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Sugiu
authors.forename: Kenji
authors.initials: K
authors.lastname: Takahashi
authors.forename: Koji
authors.initials: K
authors.lastname: Muneta
authors.forename: Takashi
authors.initials: T
authors.lastname: Ohmoto
mesh_terms: D000784:Aortic Dissection / Q000150:complications / Q000601:surgery*; D017542:Aneurysm, Ruptured / Q000150:complications / Q000601:surgery*; D004621:Embolization, Therapeutic / Q000379:methods*; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D015607:Stents; D013345:Subarachnoid Hemorrhage / Q000209:etiology*; D014656:Vascular Surgical Procedures / Q000379:methods*; D014711:Vertebral Artery / Q000473:pathology* / Q000601:surgery*