Abstract
The optimal treatment strategy for ruptured intracranial dissecting aneurysms involving essential vessels remains controversial. The aim of this study was to review the safety and efficacy of endovascular treatment at our center. A total of 11 ruptured intracranial dissecting aneurysms involving branching arteries or arising from a major intracranial vessel without tolerance of parental artery occlusion were treated consecutively using endovascular techniques from January 2013 through December 2017. The lesions involved 4 internal carotid arteries, 2 basilar arteries, 3 vertebral arteries, and 2 posterior cerebral arteries. Clinical outcome and complications were evaluated retrospectively. Nine patients were initially treated by stent-assisted coiling, whereas 2 underwent initial coil embolization followed by stent-assisted coiling. Five patients required additional treatment because of rebleeding in 2 patients and re-expansion of the aneurysm in 3 patients. Anatomic preservation of parental, branching, and perforating arteries was successful in all patients, but thromboembolic complications related to an involved vessel occurred in 1 patient. After a mean follow-up period of 36 months (range, 10-63 months), the clinical outcome was good (modified Rankin scale score 0-2) in 9 patients, whereas 2 patients had a poor outcome (modified Rankin scale: 3 and 5) because of vasospasm-related delayed cerebral infarction. Careful follow-up is necessary after endovascular coiling for ruptured dissecting aneurysm involving essential vessels. Although additional treatment might be required, stent-assisted coiling could be a less invasive and feasible method for handling these difficult lesions.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.