title: Triple Stent Therapy for the Treatment of Vertebral Dissecting Aneurysms: Efficacy and Safety.
abstract: BACKGROUND
  There are several treatment modalities for vertebral dissecting aneurysms. The purpose of this study was to evaluate the efficacy and safety of triple stent therapy for intracranial vertebral dissecting aneurysm (VDA).
  
  
  METHODS
  Eight patients with 9 VDAs underwent multiple stent insertion therapy. Seven patients who presented with progressive ischemic symptoms and showed changes in follow-up images underwent triple stent insertion therapy, and 1 patient who presented with subarachnoid hemorrhage underwent double stent therapy twice and 1 additional single stent therapy with coil embolization (total 5 stents). Safety, technical feasibility, clinical, and imaging follow-up data for triple stent therapy were retrospectively evaluated.
  
  
  RESULTS
  Triple stent deployment for VDAs was successfully performed in all 9 VDAs without any procedure-related complication. Among them, 8 unruptured VDAs showed near normalization on follow-up imaging studies within 90 days after the procedure. One case of ruptured VDA showed repeated recurrence without new symptoms and delayed normalization after insertion of 5 stents. Seven patients with long-term follow-up (median clinical follow-up, 22.6 months; median imaging follow-up, 17.1 months) showed clinical and imaging improvement without development of new symptoms.
  
  
  CONCLUSIONS
  Triple stent therapy for VDAs was safe and effective. This technique showed favorable results in clinical and imaging follow-up for unruptured VDAs, although caution is advised for ruptured VDAs.
authors.affiliation: Department of Medicine, Graduate School, Kyung Hee University, Seoul, South Korea.
authors.forename: Yeongu
authors.initials: Y
authors.lastname: Chung
authors.affiliation: Department of Neurosurgery, College of Medicine, Kyung Hee University, Kyung Hee University Hospital, Seoul, South Korea.
authors.forename: Sung Ho
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Neurosurgery, College of Medicine, Kyung Hee University, Kyung Hee University Hospital, Seoul, South Korea.
authors.forename: Seok Keun
authors.initials: SK
authors.lastname: Choi
authors.affiliation: Department of Neurology, College of Medicine, Kyung Hee University, Kyung Hee University Hospital, Seoul, South Korea.
authors.forename: Bum Joon
authors.initials: BJ
authors.lastname: Kim
authors.affiliation: Department of Radiology, College of Medicine, Kyung Hee University, Kyung Hee University Hospital, Seoul, South Korea.
authors.forename: Kyung Mi
authors.initials: KM
authors.lastname: Lee
authors.affiliation: Department of Radiology, College of Medicine, Kyung Hee University, Kyung Hee University Hospital, Seoul, South Korea. Electronic address: euijkim@hanmail.net.
authors.forename: Eui Jong
authors.initials: EJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D001807:Blood Vessel Prosthesis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D016896:Treatment Outcome; D020217:Vertebral Artery Dissection / Q000000981:diagnostic imaging* / Q000601:surgery*
keywords: Multiple stent insertion therapy; Triple stent insertion therapy; Vertebral artery dissection; Vertebral dissecting aneurysm