title: Incidence and risk factors of recurrence after endovascular treatment of intracranial vertebrobasilar dissecting aneurysms.
abstract: OBJECTIVE
  The incidence and risk factors for recurrence after endovascular treatment of intracranial vertebrobasilar dissecting aneurysms (VBDAs) have not been studied. We aimed to evaluate the incidence and risk factors for recurrence after endovascular treatment of VBDAs.
  
  
  METHODS
  A total of 111 patients (mean age, 45±10 years) underwent endovascular treatment for 119 VBDAs (ruptured/unruptured=73:46). Incidence and risk factors for recurrence were retrospectively evaluated.
  
  
  RESULTS
  Sixty-two VBDAs were treated by a reconstructive technique by using 1 to 3 overlapping stents with or without coiling, and 57 VBDAs were treated by a deconstructive technique by using proximal occlusion or internal trapping at the dissected segment of the parent artery. Follow-up angiography was available for 97 VBDAs (81.5%) in 89 patients at 3 days to 48 months (median, 13 months) after treatment. There were 13 recurrences: 6 had rebleeding but 7 had no rebleeding. All 6 hemorrhagic recurrences had initially presented with a ruptured form. Ten recurrences were confirmed by angiography, but 3 recurrences with rebleeding did not receive follow-up angiography. The rate of post-treatment recurrence did not differ between reconstructive and deconstructive treatments. Involvement of the posterior inferior cerebellar artery origin (odds ratio=8.026; 95% confidence interval, 1.561 to 41.259; P=0.013) was the only independent risk factor for recurrence.
  
  
  CONCLUSIONS
  There was a 13% recurrence after endovascular treatment of VBDAs. Posterior inferior cerebellar artery origin involvement was the only independent risk factor for recurrence after endovascular treatment of VBDAs.
authors.affiliation: Yonsei University College of Medicine, Severance Hospital, 250 Seongsanno, 120-752, Seoul, Republic of Korea. bmoon21@hanmail.net
authors.forename: Byung Moon
authors.initials: BM
authors.lastname: Kim
authors.forename: Yong Sam
authors.initials: YS
authors.lastname: Shin
authors.forename: Se-Hyuk
authors.initials: SH
authors.lastname: Kim
authors.forename: Sang Hyun
authors.initials: SH
authors.lastname: Suh
authors.forename: Yon-Kwon
authors.initials: YK
authors.lastname: Ihn
authors.forename: Dong Ik
authors.initials: DI
authors.lastname: Kim
authors.forename: Dong Joon
authors.initials: DJ
authors.lastname: Kim
authors.forename: Sung Il
authors.initials: SI
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery*; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D015994:Incidence; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery*; D020300:Intracranial Hemorrhages / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D015607:Stents; D013997:Time Factors