title: Antegrade recanalization of a completely embolized vertebral artery after endovascular treatment of a ruptured intracranial dissecting aneurysm. Report of two cases.
abstract: Occlusion of the parent artery is a traditional method of treatment of unclippable cerebral aneurysms. Surgical or endovascular occlusion of the parent artery proximal to the aneurysm has been recommended for the treatment of dissecting aneurysms located in the vertebrobasilar circulation. Nevertheless, occlusion of the parent artery may not result in permanent exclusion of the aneurysm from the systemic circulation because, occasionally, postoperative rebleeding occurs after proximal occlusion. Alternatively, endovascular occlusion of the affected site, including the aneurysmal dilation, and parent artery, is a safe and reliable treatment for dissecting aneurysms. The authors present two rare cases of ruptured vertebral artery (VA) dissecting aneurysms that were treated by endovascular occlusion of the affected site including the aneurysm and parent artery by using Guglielmi detachable coils. In both cases the VA recanalized in an antegrade fashion during the follow-up period. Based on these unique cases, the authors suggest that a careful angiographic follow up of dissecting aneurysms is required, even in patients successfully treated with endovascular occlusion of the affected artery and aneurysm.
authors.affiliation: Department of Neurosurgery, Matsunami General Hospital, Japan. sawasawa4747@yahoo.com
authors.forename: Motoshi
authors.initials: M
authors.lastname: Sawada
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Kaku
authors.forename: Shinichi
authors.initials: S
authors.lastname: Yoshimura
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kawaguchi
authors.forename: Takashi
authors.initials: T
authors.lastname: Matsuhisa
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Hirata
authors.forename: Toru
authors.initials: T
authors.lastname: Iwama
mesh_terms: D000784:Aortic Dissection / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D017542:Aneurysm, Ruptured / Q000150:complications* / Q000628:therapy*; D002533:Cerebral Angiography; D038524:Diffusion Magnetic Resonance Imaging; D004621:Embolization, Therapeutic / Q000295:instrumentation*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D014711:Vertebral Artery / Q000000981:diagnostic imaging / Q000473:pathology