title: Endovascular treatment for ruptured vertebral artery dissecting aneurysms at the acute stage.
abstract: OBJECTIVE
  Ruptured vertebral artery dissecting aneurysms (VADA) should be treated promptly because of the high risk of rebleeding. However, it is difficult to treat dissecting aneurysm during the acute stage using microsurgery because of high intracranial pressure or brain edema. Therefore, endovascular treatment of the ruptured VADA may be a better technique. We retrospectively studied the efficacy and outcome of endovascular treatment of ruptured VADA at the acute stage.
  
  
  METHODS
  Ten patients with ruptured VADA received endovascular treatment at the acute stage. Eight patients who had dissecting aneurysms were treated by internal trapping of the dissected segment. We performed stent-assisted coiling (SAC) for a case of VADA in contralateral hypoplastic VA and a case of bilateral dissections, ruptured VADA of the right VA and VA dissection of the left VA.
  
  
  RESULTS
  Four patients had good recovery, 3 patients had moderate disability, 2 patients had severe disability, and 1 patient died from initial severe SAH. There was no rebleeding or procedure-related complication. However, one patient who was treated by SAC had ischemic complications post-treatment.
  
  
  CONCLUSIONS
  Endovascular treatment of ruptured VADA in the acute stage appears to be safe and effective.
authors.affiliation: Department of Neurological Surgery, Nihon University School of Medicine, Tokyo, Japan. suma.takeshi@nihon-u.ac.jp
authors.forename: Takeshi
authors.initials: T
authors.lastname: Suma
authors.forename: Tadashi
authors.initials: T
authors.lastname: Shibuya
authors.forename: Nobuo
authors.initials: N
authors.lastname: Kutsuna
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Takada
authors.forename: Toshinori
authors.initials: T
authors.lastname: Matsuzaki
authors.forename: Shin
authors.initials: S
authors.lastname: Nakamura
authors.forename: Teruyasu
authors.initials: T
authors.lastname: Hirayama
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Katayama
mesh_terms: D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000150:complications / Q000601:surgery*; D017023:Coronary Angiography; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D020217:Vertebral Artery Dissection / Q000150:complications / Q000601:surgery*