Angiographic and clinical outcomes of stent-alone treatment for spontaneous vertebrobasilar dissecting aneurysm.
OBJECTIVE
Spontaneous vertebrobasilar dissecting aneurysm (VBD) is a very challenging disease with an unpredictable clinical course and controversies on treatment strategy. The present study reports radiological and clinical outcomes of stent-alone treatment (SAT) for VBD.


METHODS
Twenty-four VBDs treated with SAT are included in the present study. Clinical and angiographic data were reviewed retrospectively.


RESULTS
A total of 24 lesions in 22 patients with a mean follow-up period of 16.21 months were included. Of the 24 individual lesions, 23 were intracranial vertebral artery lesions and 1 lesion was located in the basilar artery. There were six cases of ruptured dissections with the other cases having various symptoms. The immediate post-SAT angiographic outcomes included 5 lesions with good remodeling over 90% recovery and 19 poorly remodeled lesions. The latest angiographic outcomes included 17 cases of good remodeling (remodeling rate over 90%), 6 cases of poor remodeling (remodeling rate below 70%), and 1 case with morphological aggravation. The overlapping stent technique was used in seven cases and it was significantly associated with good angiographic results. None of the rupture cases underwent re-rupture post SAT. There was one case of a symptomatic complication of a femoral arteriovenous fistula.


CONCLUSIONS
The SAT could be a feasible alternative for the treatment of VBD. The overlapping technique was significantly associated with good angiographic outcome. We expect that technological development of the intracranial stent will allow better procedural outcomes of SAT.
Department of Neurosurgery, Holy Family Hospital, The Catholic University of Korea, Sosa-dong, Wonmi-gu, Bucheon, Gyeonggi-do 429-717, Republic of Korea.
Won Ki
WK
Yoon
Young Woo
YW
Kim
Seong-Rim
SR
Kim
Ik Seong
IS
Park
Sang Don
SD
Kim
Kwang Wook
KW
Jo
Min Woo
MW
Baik
D000328:Adult; D000368:Aged; D004621:Embolization, Therapeutic / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D020217:Vertebral Artery Dissection / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D055815:Young Adult