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Flow diverter for the treatment of large (> 10 mm) vertebral artery dissecting aneurysms

Authors
 Woosung Lee  ;  Hyun Jin Han  ;  Junhyung Kim  ;  Keun Young Park  ;  Yong Bae Kim  ;  Chang Ki Jang  ;  Joonho Chung 
Citation
 ACTA NEUROCHIRURGICA, Vol.164(5) : 1247-1254, 2022-05 
Journal Title
ACTA NEUROCHIRURGICA
ISSN
 0001-6268 
Issue Date
2022-05
MeSH
Cerebral Angiography ; Endovascular Procedures* / methods ; Female ; Follow-Up Studies ; Humans ; Intracranial Aneurysm* / diagnostic imaging ; Intracranial Aneurysm* / surgery ; Male ; Middle Aged ; Retrospective Studies ; Stents ; Treatment Outcome ; Vertebral Artery / diagnostic imaging ; Vertebral Artery / surgery ; Vertebral Artery Dissection* / diagnostic imaging ; Vertebral Artery Dissection* / surgery
Keywords
Dissecting aneurysm ; Endovascular treatment ; Flow diverter ; Vertebral artery ; Vertebral artery dissection
Abstract
Objective: To evaluate the outcomes of flow-diverting device (FDD) treatment for large vertebral artery dissecting aneurysms (VADAs).

Methods: This retrospective study evaluated 12 patients with 12 VADAs who were treated using FDD between 2013 and 2020. Clinical and radiographic data, including procedure-related complications and clinical outcomes assessed using the modified Rankin Scale (mRS) at the time of the last follow-up, were collected and reviewed.

Results: All 12 patients had unruptured aneurysms. There were 3 (25%) female and 9 (75%) male patients, and the mean patient age was 54.6 years. The mean size of the aneurysm was 15.9 ± 4.8 mm. The mean follow-up duration was 15.8 months. Single FDD without additional coils was used in all patients. One patient underwent second-line treatment with FDD for recurrence of large VADA after stent-assisted coiling. Immediate follow-up angiography after placement of the FDD demonstrated intra-aneurysmal contrast stasis. There were 2 (17%) patients who had peri-procedural stroke. Angiography at the 6-month follow-up in 10 patients showed favorable occlusion (OKM grade C3 + D). A total of 11 (92%) patients had good clinical outcome (modified Rankin Scale ≤ 2) at the last follow-up. No re-treatment or delayed aneurysm rupture occurred during the follow-up period.

Conclusions: Reconstructive technique with FDD is a feasible and effective modality for the treatment of large VADAs, showing favorable occlusion rate and clinical outcome.
Full Text
https://link.springer.com/article/10.1007/s00701-021-04965-2
DOI
10.1007/s00701-021-04965-2
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Yong Bae(김용배) ORCID logo https://orcid.org/0000-0003-2262-7157
Kim, Junhyung(김준형) ORCID logo https://orcid.org/0000-0002-8908-978X
Park, Keun Young(박근영)
Jang, Chang Ki(장창기) ORCID logo https://orcid.org/0000-0001-8715-8844
Chung, Joon Ho(정준호)
Han, Hyun Jin(한현진) ORCID logo https://orcid.org/0000-0002-4111-4819
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/189467
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