Application of covered stent grafts for intracranial vertebral artery dissecting aneurysms.
OBJECTIVE
Utilization of covered stent grafts in treating neurovascular disorders has been reported, but their efficacy and safety in vertebral artery (VA) dissecting aneurysms needs further investigation.


METHODS
Six cases are presented involving VA dissecting aneurysms that were treated by positioning a covered stent graft. Two aneurysms were located distal to the posterior inferior cerebellar artery, and 4 were located proximal to the posterior inferior cerebellar artery. Aspirin as well as ticlopidine or clopidogrel were administered after the procedure to prevent stent-related thrombosis. All patients were followed up both angiographically and clinically.


RESULTS
Five of the 6 patients underwent successful placement of a covered stent graft. The covered stent could not reach the level of the aneurysm in 1 patient with serious vasospasm who died secondary to severe subarachnoid hemorrhage that occurred 3 days later. Patient follow-up ranged from 6 to 14 months (mean 10.4 months), and demonstrated complete stabilization of the obliterated aneurysms, and no obvious intimal hyperplasia. No procedure-related complications such as stenosis or embolization occurred in the 5 patients with successful stent graft placement.


CONCLUSIONS
Although long-term follow-up studies using a greater number of patients is required for further validation of this technique, this preliminary assessment shows that covered stent graft placement is an efficient, safe, and microinvasive technique, and is a promising tool in treating intracranial VA dissecting aneurysms.
Department of Neurosurgery, West China Hospital, West China Clinical Medical School, Sichuan University, Chengdu, Sichuan Province, People's Republic of China.
Min
M
He
Heng
H
Zhang
Ding
D
Lei
Bo-Yong
BY
Mao
Chao
C
You
Xiao-Dong
XD
Xie
Hong
H
Sun
Yan
Y
Ju
Jia-Ming
JM
Zhang
D000328:Adult; D000784:Aortic Dissection / Q000628:therapy*; D000077144:Clopidogrel; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D002532:Intracranial Aneurysm / Q000628:therapy*; D020767:Intracranial Thrombosis / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D015607:Stents; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D016896:Treatment Outcome; D014711:Vertebral Artery
D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine