title: The interaction between stent(s) implantation, PICA involvement, and immediate occlusion degree affect symptomatic intracranial spontaneous vertebral artery dissection aneurysm (sis-VADA) recurrence after reconstructive treatment with stent(s)-assisted coiling.
abstract: OBJECTIVE
  We aimed to evaluate risk factors of sis-VADAs recurrence after reconstructive treatment based on 113 reconstructed lesions.
  
  
  METHODS
  A total of 111 patients (M:F = 68:43; median age, 47 years) with 113 sis-VADAs underwent reconstruction from October 2000 to March 2011, using stent(s) and coils. Treatments and predictors of recurrence were retrospectively analysed.
  
  
  RESULTS
  Fifty-eight sis-VADAs underwent single-stent treatment, and the remaining 55 sis-VADAs underwent treatment with 2-4 overlapping stents. Follow-up angiography was available for 94 sis-VADAs 12 -78 months, with recurrence in ten patients, including seven angiographic recurrences and three post-treatment haemorrhagic recurrences. A higher rate of post-treatment recurrence was observed in the single stent group than in the multiple stents group (p = 0.010). The interaction between stent (s) implantation and immediate occlusion degree (odds ratio [OR] =3.152; 95% confidence interval [CI], 1.293-7.686; p = 0.012), between stent (s) implantation and the posterior inferior cerebellar artery (PICA) involvement (OR = 4.607; 95% CI, 1.172-18.113; p = 0.029), and between PICA involvement and immediate occlusion degree (OR = 5.018; 95% CI, 1.263-19.933; p = 0.022) affect recurrence in the reconstructed sis-VADAs.
  
  
  CONCLUSIONS
  This single centre cohort study indicated that the interaction effect between stent (s) implantation, PICA involvement, and immediate occlusion degree were closely associated with recurrence after reconstructive treatment of sis-VADA.
  
  
  CONCLUSIONS
  The interaction between stent (s) and immediate occlusion degree affect aneurysmal recurrence. The interaction between stent and PICA involvement affect aneurysmal recurrence. The interaction between PICA involvement and immediate occlusion degree affect aneurysmal recurrence.
authors.affiliation: Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China, zkjwcfzwh@163.com.
authors.forename: Kai-Jun
authors.initials: KJ
authors.lastname: Zhao
authors.forename: Rui
authors.initials: R
authors.lastname: Zhao
authors.forename: Qing-Hai
authors.initials: QH
authors.lastname: Huang
authors.forename: Yi
authors.initials: Y
authors.lastname: Xu
authors.forename: Bo
authors.initials: B
authors.lastname: Hong
authors.forename: Yi-Bin
authors.initials: YB
authors.lastname: Fang
authors.forename: Qiang
authors.initials: Q
authors.lastname: Li
authors.forename: Peng-Fei
authors.initials: PF
authors.lastname: Yang
authors.forename: Jian-Min
authors.initials: JM
authors.lastname: Liu
authors.forename: Wen-Yuan
authors.initials: WY
authors.lastname: Zhao
mesh_terms: D000328:Adult; D000368:Aged; D001807:Blood Vessel Prosthesis; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic / Q000295:instrumentation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D020769:Posterior Cerebral Artery / Q000473:pathology* / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D012008:Recurrence; D012189:Retrospective Studies; D015607:Stents; D014711:Vertebral Artery / Q000000981:diagnostic imaging* / Q000601:surgery; D020217:Vertebral Artery Dissection / Q000000981:diagnostic imaging / Q000628:therapy*