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Clinical and angiographic follow-up of stent-only therapy for acute intracranial vertebrobasilar dissecting aneurysms.

Authors
 B.M. Kim  ;  D.I. Kim  ;  Y.S. Shin  ;  S.H. Suh  ;  E.C. Chung  ;  S.Y. Kim  ;  S.H. Kim  ;  Y.S. Won 
Citation
 AMERICAN JOURNAL OF NEURORADIOLOGY, Vol.30(7) : 1351-1356, 2009 
Journal Title
 AMERICAN JOURNAL OF NEURORADIOLOGY 
ISSN
 0195-6108 
Issue Date
2009
MeSH
Adult Aged Aneurysm, Dissecting/diagnostic imaging* Aneurysm, Dissecting/surgery* Blood Vessel Prosthesis* Cerebral Angiography/methods* Female Humans Intracranial Aneurysm/diagnostic imaging* Intracranial Aneurysm/surgery* Male Middle Aged Stents* Treatment Outcome Vertebral Artery Dissection/diagnostic imaging Vertebral Artery Dissection/surgery
Abstract
BACKGROUND AND PURPOSE: Little has been known about the clinical and angiographic follow-up results of stent-only therapy for intracranial vertebrobasilar dissecting aneurysms (VBDA). The purpose of this study was to evaluate the feasibility, safety, clinical, and angiographic follow-up of stent-only therapy for VBDA. MATERIALS AND METHODS: Twenty-seven patients with 29 VBDAs (11 ruptured, 18 unruptured), not suitable for deconstructive treatment, underwent stent-only therapy. Feasibility, safety, clinical, and angiographic follow-up were retrospectively evaluated. Angiographic outcomes were compared between single-stent and multiple-stent groups. RESULTS: All attempted stent placements were successfully accomplished without any treatment-related complication. Of the 11 ruptured VBDAs, 4 were treated by single stents, 6 by double overlapping stents, and 1 by triple overlapping stents. Of the 18 unruptured VBDAs, 6 were treated by stents, and 12 by double overlapping stents. One patient with a ruptured VBDA, treated by single stent, had rebleeding and died. None of the remaining patients had posttreatment bleeding during follow-up (mean, 28 months; range, 7-50 months). Eight patients with ruptured VBDA and all patients with unruptured VBDA had excellent outcomes (modified Rankin Scale, 0-1). The remaining 2 patients with ruptured VBDA were moderately disabled because of the initial damage. Angiographic follow-up was available in 27 VBDAs, 4 to 42 months (mean, 12 months) after treatment. Follow-up angiograms revealed complete obliteration of the dissecting aneurysm in 12, partial obliteration in 12, stable in 1, enlargement in 1, and in-stent occlusion in 1. Angiographic improvement (complete or partial obliteration) was more frequent in the multiple-stent group (17/17) than in the single-stent group (7/9; P < .05). CONCLUSIONS: In this small series, stent-only therapy was safe and effective in the treatment of VBDAs that were not deemed suitable for treatment with parent-artery occlusion
Files in This Item:
T200902391.pdf Download
DOI
10.3174/ajnr.A1561
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Ik(김동익)
Kim, Byung Moon(김병문) ORCID logo https://orcid.org/0000-0001-8593-6841
Kim, Se Hyuk(김세혁)
Park, Sung Il(박성일)
Suh, Sang Hyun(서상현) ORCID logo https://orcid.org/0000-0002-7098-4901
Shin, Yong Sam(신용삼)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/104156
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