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Endovascular Treatment Using Multiple Stents for Symptomatic Intracranial Vertebral Artery Dissecting Aneurysm.

Authors
 Ju Hyung Moon  ;  Chang Ki Hong  ;  Sang Hyun Suh  ;  Jung Yong Ahn  ;  Jin Yang Joo  ;  Young Min Kwon 
Citation
 Korean Journal of Cerebrovascular Surgery (대한뇌혈관외과학회지), Vol.11(4) : 183-192, 2009 
Journal Title
 Korean Journal of Cerebrovascular Surgery (대한뇌혈관외과학회지) 
ISSN
 1738-0499 
Issue Date
2009
Keywords
Vertebral artery ; Dissecting aneurysm ; Stent ; Endovascular treatment
Abstract
OBJECTIVE: Endovascular treatment with stent placement or stent-assisted coiling was recently introduced as an alternative to parent artery occlusion for treating intracranial vertebral artery dissections. However, complete aneurysm obliteration after single stent placement is often not accomplished. The aim of the study was to evaluate the safety and efficacy of placing multiple stents in intracranial vertebral dissecting aneurysms. METHODS: We retrospectively reviewed 8 patients who underwent stent angioplasty with placing multiple stents for treating intracranial vertebral dissecting aneurysms. There were 5 male patients and 3 female patients with a mean age of 54 years (age range, 37-71 years). Three patients presented with subarachnoid hemorrhage (SAH), 1 presented with ischemic events and 4 presented with headache. Follow-up angiogram was performed in 8 patients within 6~12 months to determine whether or not the affected segment was occluded. RESULTS: Eight patients with intracranial vertebral artery dissections were treated by placing multiple stents, 6 were treated by double stent placement and the others were treated by triple and quadruple stent placement. Although immediate complete occlusion was not shown in any cases, the follow-up angiogram revealed complete occlusion in 5 cases (62.5%) within 6-12 months. There were 2 complications (25%, temporary vasospasm during the procedure and acute thrombosis). On the modified Rankin scale applied during follow-up, 6 patients were ssessed as functionally improved or of a stable clinical status, 1 patient expired due to cardiopulmonary complications, and 1 was lost to follow-up). CONCLUSION: Intracranial vertebral artery dissections can be treated by the endovascular method with placing multiple stents and the morbidity is acceptable. However, further study is needed since the treatment of patients presenting with SAH using multiple stent placement can be controversial
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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
Kwon, Young Min(권영민)
Suh, Sang Hyun(서상현) ORCID logo https://orcid.org/0000-0002-7098-4901
Ahn, Jung Yong(안정용)
Joo, Jin Yang(주진양)
Hong, Chang Ki(홍창기)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/105858
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