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Incidence and risk factors of recurrence after endovascular treatment of intracranial vertebrobasilar dissecting aneurysms.

Authors
 Byung Moon Kim ; Yong Sam Shin ; Sung Il Park ; Dong Joon Kim ; Dong Ik Kim ; Yon-Kwon Ihn ; Sang Hyun Suh ; Se-Hyuk Kim 
Citation
 Stroke, Vol.42(9) : 2425~2430, 2011 
Journal Title
 Stroke 
ISSN
 0039-2499 
Issue Date
2011
Abstract
BACKGROUND AND PURPOSE: 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.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/93622
DOI
10.1161/STROKEAHA.111.617381
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Radiology
Yonsei Authors
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