Endovascular Treatment of Intracranial Vertebral Artery Dissections with Stent Placement or Stent-assisted Coiling
J.Y. Ahna,
I.B. Hanc,
T.G. Kimc,
P.H. Yoond,
Y.J. Leed,
B.-H. Leee,
S.H. Seob,
D.I. Kimb,
C.K. Honga and
J.Y. Jooa
a Department of Neurosurgery, Yonsei University College of Medicine, Seoul, South Korea
b Department of Diagnostic Radiology, Yonsei University College of Medicine, Seoul, South Korea
c Department of Neurosurgery, Pochon CHA University, Sungnam, South Korea
d Department of Diagnostic Radiology, Pochon CHA University, Sungnam, South Korea
e Department of Diagnostic Radiology, Eulji University Hospital, Daejeon, South Korea
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Fig. 1. Images from the case of a 50-year-old woman (patient 7) who had a fusiform aneurysm of the distal intracranial left vertebral artery.
A, Anteroposterior projection angiogram of the left vertebral artery disclosed a fusiform aneurysm of the distal intracranial portion (arrow) that is proximal to the vertebrobasilar junction and distal to the left posterior inferior cerebellar artery (PICA, double arrows).
B, Unsubtracted image demonstrates the deployed stent (arrows) across the aneurysm.
C, Anteroposterior projection angiogram obtained immediately after stent placement demonstrates no change in the fusiform aneurysm.
D, Angiogram obtained 19 months after stent deployment reveals no occlusion of the aneurysm.
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Fig. 2. Angiograms in a 37-year-old man (patient 5) with dissecting aneurysm of the distal intracranial left vertebral artery treated with double stent method.
A, Anteroposterior projection shows a dissecting aneurysm of the distal intracranial left vertebral artery (arrow).
B, Angiogram obtained immediately after double stent placement demonstrates partial resolution of the aneurysm.
C, Angiogram obtained 6 months after double stent placement demonstrates complete healing of the aneurysm with restoration of the normal lumen.
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Fig. 3. Angiograms in a 52-year-old man (patient 11) with dissecting aneurysm of the distal intracranial right vertebral artery treated with stent-assisted coiling.
A, The stent was placed across the aneurysm neck.
B, The aneurysm is occluded incompletely with coils.
C, Digital subtraction angiogram shows nearly completely occluded aneurysm with preservation of the parent artery.
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Fig. 4. Images from the case of a 55-year-old woman (patient 9) who had suffered SAH from a wide-necked aneurysm of the distal intracranial right vertebral artery.
A, Anteroposterior projection angiogram of the right vertebral artery disclosed an aneurysm of the distal intracranial portion that is proximal to the vertebrobasilar junction and distal to the right posterior inferior cerebellar artery.
B, The aneurysm was occluded near completely with coils.
C, Angiogram obtained 3 months after stent-assisted coiling demonstrates recanalization of the neck.
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