Yeongu Chung1, Sung Ho Lee2, Seok Keun Choi2, Bum Joon Kim3, Kyung Mi Lee4, Eui Jong Kim5. 1. Department of Medicine, Graduate School, Kyung Hee University, Seoul, South Korea. 2. Department of Neurosurgery, College of Medicine, Kyung Hee University, Kyung Hee University Hospital, Seoul, South Korea. 3. Department of Neurology, College of Medicine, Kyung Hee University, Kyung Hee University Hospital, Seoul, South Korea. 4. Department of Radiology, College of Medicine, Kyung Hee University, Kyung Hee University Hospital, Seoul, South Korea. 5. Department of Radiology, College of Medicine, Kyung Hee University, Kyung Hee University Hospital, Seoul, South Korea. Electronic address: euijkim@hanmail.net.
Abstract
BACKGROUND: There are several treatment modalities for vertebral dissecting aneurysms. The purpose of this study was to evaluate the efficacy and safety of triple stent therapy for intracranial vertebral dissecting aneurysm (VDA). METHODS: Eight patients with 9 VDAs underwent multiple stent insertion therapy. Seven patients who presented with progressive ischemic symptoms and showed changes in follow-up images underwent triple stent insertion therapy, and 1 patient who presented with subarachnoid hemorrhage underwent double stent therapy twice and 1 additional single stent therapy with coil embolization (total 5 stents). Safety, technical feasibility, clinical, and imaging follow-up data for triple stent therapy were retrospectively evaluated. RESULTS: Triple stent deployment for VDAs was successfully performed in all 9 VDAs without any procedure-related complication. Among them, 8 unruptured VDAs showed near normalization on follow-up imaging studies within 90 days after the procedure. One case of ruptured VDA showed repeated recurrence without new symptoms and delayed normalization after insertion of 5 stents. Seven patients with long-term follow-up (median clinical follow-up, 22.6 months; median imaging follow-up, 17.1 months) showed clinical and imaging improvement without development of new symptoms. CONCLUSIONS: Triple stent therapy for VDAs was safe and effective. This technique showed favorable results in clinical and imaging follow-up for unruptured VDAs, although caution is advised for ruptured VDAs.
BACKGROUND: There are several treatment modalities for vertebral dissecting aneurysms. The purpose of this study was to evaluate the efficacy and safety of triple stent therapy for intracranial vertebral dissecting aneurysm (VDA). METHODS: Eight patients with 9 VDAs underwent multiple stent insertion therapy. Seven patients who presented with progressive ischemic symptoms and showed changes in follow-up images underwent triple stent insertion therapy, and 1 patient who presented with subarachnoid hemorrhage underwent double stent therapy twice and 1 additional single stent therapy with coil embolization (total 5 stents). Safety, technical feasibility, clinical, and imaging follow-up data for triple stent therapy were retrospectively evaluated. RESULTS: Triple stent deployment for VDAs was successfully performed in all 9 VDAs without any procedure-related complication. Among them, 8 unruptured VDAs showed near normalization on follow-up imaging studies within 90 days after the procedure. One case of ruptured VDA showed repeated recurrence without new symptoms and delayed normalization after insertion of 5 stents. Seven patients with long-term follow-up (median clinical follow-up, 22.6 months; median imaging follow-up, 17.1 months) showed clinical and imaging improvement without development of new symptoms. CONCLUSIONS: Triple stent therapy for VDAs was safe and effective. This technique showed favorable results in clinical and imaging follow-up for unruptured VDAs, although caution is advised for ruptured VDAs.
Authors: Yi Gu; Li Chen; Yang Zhang; Mo Chen; YongDong Li; YueQi Zhu; HaiTao Lu; LiMing Wei; PeiLei Zhang; MinHua Li; BinXian Gu; Jin You; Wu Wang Journal: J Interv Med Date: 2020-08-16