title: Endovascular management of vertebral artery dissecting aneurysms: review of 25 patients.
abstract: OBJECTIVE
  Management of Vertebral Artery (VA) dissections remains controversial. The clinical and angiographic variables of VA dissections were evaluated to demonstrate the safety and efficacy of endovascular intervention in treatment of VA dissecting aneurysms.
  
  
  METHODS
  25 patients with 27 VAdissecting aneurysms were treated with endovascular intervention during the last 10 years.17 patients were admitted with subarachnoid hemorrhage. 23 aneurysms treated using destructive endovascular trapping, while reconstructive techniques were used in 3 aneurysms treated with stent-assisted coiling and one aneurysm treated with false lumen embolization.
  
  
  RESULTS
  The right VA was involved in 14 patients, the left VA in 9 patients, while 2 patients had bilateral VA dissection. The pearl and string sign was the commonest angiographic sign in 12 aneurysms. Perioperative complications included; rebleeding in one patient, symptomatic brain stem infarction in two patients and silent cerebellar ischemic lesion in one patient. Afavorable outcome was evident more in patients with unruptured VA dissection (100%) versus (76.5%) in patients presented with SAH.
  
  
  CONCLUSIONS
  The endovascular technique should be individualized according to the clinical status of the patient, angiographic variables, condition of the posterior circulation and the available supplies.
authors.affiliation: Department of Neurosurgery, Zagazig University, Zagazig, Egypt. mahmoudlotfy1972@yahoo.co.uk
authors.forename: Mahmoud M
authors.initials: MM
authors.lastname: Taha
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sakaida
authors.forename: Fumio
authors.initials: F
authors.lastname: Asakura
authors.forename: Masayuki
authors.initials: M
authors.lastname: Maeda
authors.forename: Naoki
authors.initials: N
authors.lastname: Toma
authors.forename: Akitaka
authors.initials: A
authors.lastname: Yamamoto
authors.forename: Kenji
authors.initials: K
authors.lastname: Kawaguchi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Matsushima
authors.forename: W
authors.initials: W
authors.lastname: Taki
mesh_terms: D000328:Adult; D000368:Aged; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D015607:Stents; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging / Q000453:epidemiology; D014711:Vertebral Artery / Q000000981:diagnostic imaging*; D020217:Vertebral Artery Dissection / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000628:therapy*