Angiographic and clinical outcomes of stent-alone treatment for spontaneous vertebrobasilar dissecting aneurysm

被引:41
作者
Yoon, Won Ki [1 ]
Kim, Young Woo [1 ]
Kim, Seong-Rim [1 ]
Park, Ik Seong [1 ]
Kim, Sang Don [1 ]
Jo, Kwang Wook [1 ]
Baik, Min Woo [1 ]
机构
[1] Catholic Univ Korea, Holy Family Hosp, Dept Neurosurg, Puchon 429717, Gyeonggi Do, South Korea
关键词
Aneurysm; Angiography; Stent; Vertebrobasilar dissection; VERTEBRAL ARTERY DISSECTION; ENDOVASCULAR TREATMENT; INTRACRANIAL ANEURYSMS; COIL EMBOLIZATION; NEUROFORM STENT; NATURAL-HISTORY; FUSIFORM; PLACEMENT; RECONSTRUCTION; ANGIOPLASTY;
D O I
10.1007/s00701-010-0693-7
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Spontaneous vertebrobasilar dissecting aneurysm (VBD) is a very challenging disease with an unpredictable clinical course and controversies on treatment strategy. The present study reports radiological and clinical outcomes of stent-alone treatment (SAT) for VBD. Twenty-four VBDs treated with SAT are included in the present study. Clinical and angiographic data were reviewed retrospectively. A total of 24 lesions in 22 patients with a mean follow-up period of 16.21 months were included. Of the 24 individual lesions, 23 were intracranial vertebral artery lesions and 1 lesion was located in the basilar artery. There were six cases of ruptured dissections with the other cases having various symptoms. The immediate post-SAT angiographic outcomes included 5 lesions with good remodeling over 90% recovery and 19 poorly remodeled lesions. The latest angiographic outcomes included 17 cases of good remodeling (remodeling rate over 90%), 6 cases of poor remodeling (remodeling rate below 70%), and 1 case with morphological aggravation. The overlapping stent technique was used in seven cases and it was significantly associated with good angiographic results. None of the rupture cases underwent re-rupture post SAT. There was one case of a symptomatic complication of a femoral arteriovenous fistula. The SAT could be a feasible alternative for the treatment of VBD. The overlapping technique was significantly associated with good angiographic outcome. We expect that technological development of the intracranial stent will allow better procedural outcomes of SAT.
引用
收藏
页码:1477 / 1486
页数:10
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