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Antegrade Recanalization of Parent Artery after Internal Trapping of Ruptured Vertebral Artery Dissecting Aneurysm

  • Ihn, Yon-Kwon (Department of Radiology, St.Vincent's Hospital, The Catholic University of Korea) ;
  • Sung, Jae-Hoon (Department of Neurosurgery, St.Vincent's Hospital, The Catholic University of Korea) ;
  • Byun, Je-Hoon (Department of Neurosurgery, St.Vincent's Hospital, The Catholic University of Korea)
  • Received : 2011.11.17
  • Accepted : 2012.05.15
  • Published : 2012.05.28

Abstract

We report a patient with a ruptured vertebral artery (VA) dissecting aneurysm that was treated by internal trapping of the aneurysm and parent artery using detachable coils with subsequent antegrade recanalization of occluded vertebral artery during the follow-up period. A 38-year-old man was admitted with a ruptured right VA dissecting aneurysm just distal to origin of right posterior inferior cerebellar artery. The dissected segment of the VA was occluded by coil embolization. The 14 months follow-up angiography showed that dissected aneurysm was completely occluded, but the parent artery was recanalized in an antegrade fashion. Based on this unique case, the authors suggest that careful angiographic follow-up of dissecting aneurysm is required, even in patients successfully treated with endovascular occlusion of the affected artery and aneurysm.

Keywords

References

  1. Baik SK, Kim YS, Lee HJ, Park J, Kang DS : Antegrade recanalization of parent artery in internal trapping of vertebral artery dissecting aneurysm : a case report. Surg Neurol 68 : 108-111; discussion 111, 2007 https://doi.org/10.1016/j.surneu.2006.07.023
  2. Iihara K, Sakai N, Murao K, Sakai H, Higashi T, Kogure S, et al. : Dissecting aneurysms of the vertebral artery : a management strategy. J Neurosurg 97 : 259-267, 2002 https://doi.org/10.3171/jns.2002.97.2.0259
  3. Jin SC, Kwon DH, Choi CG, Ahn JS, Kwun BD : Endovascular strategies for vertebrobasilar dissecting aneurysms. AJNR Am J Neuroradiol 30 : 1518-1523, 2009 https://doi.org/10.3174/ajnr.A1621
  4. Kim BM, Shin YS, Kim SH, Suh SH, Ihn YK, Kim DI, et al. : Incidence and risk factors of recurrence after endovascular treatment of intracranial vertebrobasilar dissecting aneurysms. Stroke 42 : 2425-2430, 2011 https://doi.org/10.1161/STROKEAHA.111.617381
  5. MacKay CI, Han PP, Albuquerque FC, McDougall CG : Recurrence of a vertebral artery dissecting pseudoaneurysm after successful stent-supported coil embolization : case report. Neurosurgery 53 : 754-759; discussion 760-761, 2003 https://doi.org/10.1227/01.NEU.0000080065.49651.48
  6. Mizutani T, Aruga T, Kirino T, Miki Y, Saito I, Tsuchida T : Recurrent subarachnoid hemorrhage from untreated ruptured vertebrobasilar dissecting aneurysms. Neurosurgery 36 : 905-911; discussion 912-913, 1995 https://doi.org/10.1227/00006123-199505000-00003
  7. Mizutani T, Kojima H, Asamoto S : Healing process for cerebral dissecting aneurysms presenting with subarachnoid hemorrhage. Neurosurgery 54 : 342-347; discussion 347-348, 2004 https://doi.org/10.1227/01.NEU.0000103449.80484.7E
  8. Rabinov JD, Hellinger FR, Morris PP, Ogilvy CS, Putman CM : Endovascular management of vertebrobasilar dissecting aneurysms. AJNR Am J Neuroradiol 24 : 1421-1428, 2003
  9. Sawada M, Kaku Y, Yoshimura S, Kawaguchi M, Matsuhisa T, Hirata T, et al. : Antegrade recanalization of a completely embolized vertebral artery after endovascular treatment of a ruptured intracranial dissecting aneurysm. Report of two cases. J Neurosurg 102 : 161-166, 2005 https://doi.org/10.3171/jns.2005.102.1.0161
  10. Sugiu K, Tokunaga K, Watanabe K, Sasahara W, Ono S, Tamiya T, et al. : Emergent endovascular treatment of ruptured vertebral artery dissecting aneurysms. Neuroradiology 47 : 158-164, 2005 https://doi.org/10.1007/s00234-005-1341-4

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  2. Endovascular interventional therapy and classification of vertebral artery dissecting aneurysms vol.8, pp.5, 2012, https://doi.org/10.3892/etm.2014.1961
  3. Endovascular Treatment of Intracranial Vertebral Artery Dissecting Aneurysms: Follow up Angiographic and Clinical Results of Endovascular Treatment in Serial Cases vol.10, pp.1, 2015, https://doi.org/10.5469/neuroint.2015.10.1.14
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