Aim: The prognosis of VBA aneurysms seems poor and surgical management of VBA dissecting aneurysms is challenging. We evaluated our endovascular experience in management of ruptured and unruptured VBA dissecting aneurysms.
Material and methods: Eleven consecutive patients with eleven VBA aneurysms (3 ruptured and 8 unruptured) between 2008 and 2010 were retrospectively reviewed.
Results: Immediate postprocedural angiograms showed complete occlusion in 5 and subtotal occlusion in 2 aneurysms treated with stentassisted coiling, whereas no occlusion in 4 aneurysms treated with stenting alone. A clinical improvement or stable outcome was achieved in all patients. There was no complication in our patients and no patient died after treatment. Angiographic follow-up (mean 9.7 months, 1 to 23 months) showed complete cure in 8 aneurysms, subtotal occlusion in 2 and no occlusion in 1.
Conclusion: VBA dissecting aneurysms can be managed by endovascular stent placement with or without coiling. In cases that cannot be treated with neurostents, proximal occlusion could be an option.