scholarly journals Vertebral Dissecting Aneurysm Treated with Wingspan Stent Deployment and Detachable Coils

2009 ◽  
Vol 15 (1) ◽  
pp. 113-116 ◽  
Author(s):  
M. Lv ◽  
X. Lv ◽  
Y. Li ◽  
X. Yang ◽  
Z. Wu
Keyword(s):  
Endovascular Treatment ◽  
Vertebral Artery ◽  
Stent Placement ◽  
Dissecting Aneurysm ◽  
Left Vertebral Artery ◽  
Stent Deployment ◽  
Detachable Coils

We describe the first documented endovascular treatment of vertebral dissecting aneurysm using a Wingspan stent and detachable coils. A 54-year-old man presented with a nonruptured vertebral dissecting aneurysm. Because of the dissecting nature of the vertebral aneurysms, a 3×15-mm Wingspan stent was placed in the left vertebral artery. One month later, several detachable coils were introduced into the aneurysm. Six-month follow-up angiogram confirmed the obliteration. Vertebral dissecting aneurysm can be treated with Wingspan stent placement and detachable coils.

scholarly journals Dissecting Aneurysm of the Vertebral Artery Developed after Microvascular Decompression for Hemifacial Spasm

2006 ◽  
Vol 12 (1_suppl) ◽  
pp. 145-147 ◽  
Author(s):  
T. Kudo ◽  
K. Iihara ◽  
K. Murao ◽  
K. Hayashi ◽  
J. Ayabe ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Hemifacial Spasm ◽  
Microvascular Decompression ◽  
De Novo ◽  
Posterior Inferior Cerebellar Artery ◽  
Dissecting Aneurysm ◽  
Left Vertebral Artery ◽  
Root Exit Zone ◽  
Detachable Coils ◽  
One Year

We report a rare case of a ruptured de novo dissecting aneurysm induced by ethyl 2-cyanoacrylate. A 39-year-old woman underwent microvascular decompression for left hemifacial spasm. The offending vessel was left posterior inferior cerebellar artery (PICA). Left vertebral artery (VA) was mobilized and affixed to the dura mater with cyanoacrylate to remove pressure of PICA to the root exit zone of the facial nerve. The left VA was found to be intact at the time of the operation. One year later, the patient sufferd subarachnoid haemorrhage (SAH) caused by rupture of a newly-developed dissecting aneurysm of the left VA. Endovascular occlusion of the dissecting site was performed using Guglielmi detachable coils. We suppose mechanical injury and chemical reaction of ethyl 2-cyanoacrylate induced dissecting aneurysm.

Emergency Endovascular Treatment of a Penetrating Vertebral Artery Injury with Detachable Coils

2005 ◽  
Vol 18 (1) ◽  
pp. 117-121
Author(s):  
H. Akan ◽  
K. Atalay ◽  
Ü. Belet ◽  
Z. Özmen ◽  
S. Gelmez
Keyword(s):  
Endovascular Treatment ◽  
Vertebral Artery ◽  
Surgical Approach ◽  
Stab Wound ◽  
Active Bleeding ◽  
Vertebral Artery Injury ◽  
Left Vertebral Artery ◽  
Artery Injury ◽  
Bony Canal ◽  
Detachable Coils

The surgical approach is difficult and time-consuming in cases of injury to the bony canal segment of the vertebral artery. Diagnosis and treatment should be performed urgently if the patient has active bleeding. We present a patient with a left vertebral artery injury in a stab wound to the neck in whom emergency endovascular treatment was performed with detachable coils because of ongoing gross bleeding.

scholarly journals Stent Placement to Treat Ruptured Vertebral Dissecting Aneurysms

2013 ◽  
Vol 19 (4) ◽  
pp. 479-482 ◽  
Author(s):  
Yong-An Chen ◽  
Rong-Bo Qu ◽  
Yu-Song Bian ◽  
Wei Zhu ◽  
Kun-Peng Zhang ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Stent Placement ◽  
Posterior Inferior Cerebellar Artery ◽  
Aneurysm Rupture ◽  
Dissecting Aneurysm ◽  
Related Complication ◽  
Cerebellar Artery ◽  
Good Patency ◽  
Dissecting Aneurysms

Conventional endovascular treatment may have limitations for vertebral dissecting aneurysm involving the origin of the posterior inferior cerebellar artery (PICA). We report our experiences of treating vertebral dissecting aneurysm with PICA origin involvement by placing a stent from the distal vertebral artery (VA) to the PICA to save the patency of the PICA. Stenting from the distal VA to the PICA was attempted to treat ruptured VA dissecting aneurysm involving the PICA origin with sufficient contralateral VA in eight patients. The procedure was successfully performed in seven patients with one failure because of PICA origin stenosis, which was treated with two overlapping stents. In the seven patients, PICAs had good patency on postoperative angiography and transient lateral brainstem ischemia represents a procedure-related complication. Follow-up angiographies were performed in seven patients and showed recanalization of the distal VA in three patients without evidence of aneurysmal filling. There was no evidence of aneurysm rupture during the follow-up period, and eight patients had favorable outcomes (mRS, 0–1). Placing a stent from the distal VA to the PICA with VA occlusion may present an alternative to conventional endovascular treatment for vertebral dissecting aneurysm with PICA origin involvement with sufficient contralateral VA.

LVIS-within-enterprise double-stent procedure without coiling beneficial as treatment of unruptured vertebral artery dissecting aneurysms

2021 ◽  
pp. 159101992110251
Author(s):  
Hyun Ho Choi ◽  
Young Dae Cho ◽  
Dong Hyun Yoo ◽  
Hyun-Seung Kang ◽  
Moon Hee Han
Keyword(s):  
Vertebral Artery ◽  
Clinical Outcomes ◽  
Local Anesthesia ◽  
Thrombus Formation ◽  
Flow Diversion ◽  
Fusiform Aneurysm ◽  
Stent Deployment ◽  
Double Stent ◽  
Dissecting Aneurysms

Stenting of vertebral artery dissecting aneurysms (VADAs) may promote mural apposition of intimal flaps, preserving the patency of injured vessels. Moreover, stent deployment may serve to alter intra-aneurysm flow, inducing saccular thrombus formation, neointimal development, and remodeling of injured vessels. Although an overlapping multistent strategy with coiling has proven successful in this setting, yielding good anatomic and clinical outcomes, coiling may be technically infeasible in some VADAs with unfavorably configured circumferential elevations. Herein, we describe three patients with VADAs for whom coiling was deemed technically problematic. Each underwent double stenting (LVIS within Enterprise), without coil insertion, using local anesthesia. Conventional angiographic follow-up regularly disclosed excellent saccular occlusion and subsequent remodeling of stented arteries. LVIS-within-Enterprise double stenting may be of particular benefit in patients with VADAs, the Enterprise providing outer support to minimize stent bulging (as a fusiform aneurysm) as the inner LVIS reinforces flow diversion.

scholarly journals Contrast-less stent placement for vertebral artery origin stenosis

2016 ◽  
Vol 23 (1) ◽  
pp. 79-83 ◽  
Author(s):  
Shinzo Ota ◽  
Yoshinobu Sekihara ◽  
Takahiro Himeno ◽  
Yasue Tanaka ◽  
Tatsuya Ohtonari
Keyword(s):  
Renal Function ◽  
Contrast Medium ◽  
Vertebral Artery ◽  
Intravascular Ultrasound ◽  
Male Patient ◽  
Stent Placement

We performed stent placement under intravascular ultrasound (IVUS), without the use of contrast medium, in a male patient in his 70s who had vertebral artery origin stenosis and decreased renal function. Satisfactory dilatation was achieved without complications, and the patient remained asymptomatic at 2 years of follow-up. We now report the details of this procedure. Stent placement under IVUS guidance may be useful in patients in whom contrast medium is contraindicated.

scholarly journals Endovascular treatment of the vertebral artery origin stenosis by using the closed-cell, self-expandable Carotid Wallstent

2020 ◽  
Vol 26 (6) ◽  
pp. 805-813
Author(s):  
Jun-Kyeung Ko ◽  
Chang-Hwa Choi ◽  
Lee Hwangbo ◽  
Hie-Bum Suh ◽  
Tae-Hong Lee ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Vertebral Artery ◽  
Good Alternative ◽  
Minor Stroke ◽  
Stent Restenosis ◽  
Vertebrobasilar Ischemia ◽  
Closed Cell ◽  
Carotid Wallstent ◽  
Permanent Neurological Deficit

Background Endovascular treatment has been considered a good alternative to surgery for symptomatic vertebral artery origin stenosis (VAOS) due to the high risk of morbidity associated with surgery. The purpose of this study was to evaluate the feasibility and efficacy of insertion of the closed-cell, self-expandable Carotid Wallstent for the treatment of VAOS. Methods The records of 72 patients with VAOS refractory to adequate medication who were treated by endovascular treatment with the Carotid Wallstent from December 2006 to November 2018 were retrospectively evaluated. Results Of the 72 patients, 43 presented with transient ischemic attacks. Forty-seven patients (65.3%) manifested other brachiocephalic stenoses; of these, 40 patients had occlusion, hypoplasia, or stenosis of the contralateral vertebral artery. Overall technical success (defined as 20% or less residual stenosis) was 100%. Procedure-related complications ( n = 8, 11.1%) included sudden asystole ( n = 1), acute in-stent thrombosis ( n = 3), minor stroke ( n = 3), and stent shortening ( n = 1). All complications were resolved without permanent neurological deficit. Angiographic follow-up (mean, 13.0 months) was achieved in 49 patients and revealed in-stent restenosis in 1 patient (2.0%) and stent malposition by shortening in 2 patients (4.1%). Follow-up records were available in 57 patients (mean 15.6 months). Three of the 57 patients ( n = 3, 5.3%) had recurrent symptoms of vertebrobasilar ischemia and none was retreated. Conclusions Endovascular treatment of symptomatic VAOS using the closed-cell, self-expandable Carotid Wallstent is technically feasible and effective in alleviating patient symptoms and for improving vertebrobasilar blood flow.

Abstract 1787: Vertebral Artery Stent Placement for Symptomatic Patients: One-Year Follow-up

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Samir N Patel ◽  
J. Stephen Jenkins ◽  
Christopher J White ◽  
Paul McMullan ◽  
J.P. Reilly ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Stent Placement ◽  
Clinical Success ◽  
High Morbidity ◽  
Symptom Resolution ◽  
Non Invasive ◽  
Procedural Success ◽  
Repeat Angiography ◽  
One Year

Background : Symptomatic vertebral artery stenosis (VAS) has a five-year stroke risk of 30%–35%. Mortality associated with posterior circulation (PC) strokes is high, ranging from 20%–30%. Surgical revascularization is rarely performed due to high morbidity and mortality. Endovascular revascularization with stents offers a potential treatment option for these patients. Methods : One hundred nine patients (116 arteries, 70% male) underwent stent placement for extracranial (91%) and intracranial (9%) VAS from 1995–2006. Symptoms included vertigo (63%), visual changes (31%), syncope (11%), ataxia (7%), and drop attack (5%). Four patients had asymptomatic critical stenosis. Sixty-one patients (56%) had bilateral VAS, 74 patients (69%) had concomitant carotid disease, and 43 patients (39%) had a prior stroke. Procedural success was defined as residual stenosis of ≤ 20% without peri-procedural stroke or death. Clinical success was defined as procedural success with symptom resolution. Restenosis was defined as angiographic narrowing within the stent of ≥ 70% or > 50% with recurrent symptoms, or evidence of severe stenosis on non-invasive imaging (ultrasound, CT, or MR). Results : Procedural and clinical success was achieved in 108 (99.1%) and 95 (94.3%) patients, respectively. At one year, follow-up was obtained in 91 patients (83.5%), 6 patients (5.5%) had died, 5 patients (5.3%) experienced a PC stroke, and 47 patients (43.1%) underwent repeat angiography and/or non-invasive imaging. Eighty-seven of the 91 patients were initially symptomatic, 69 (79.3%) of which were symptom-free at one year. Three of those that had recurrent symptoms never achieved clinical success, 9 had developed restenosis, and 7 underwent successful re-intervention. At median follow-up of 31 months (lower and upper quartiles of 13.0 and 51.8 months), 72.5% were alive and 71.6% remained symptom-free. Conclusion : Our data demonstrates that stenting for VAS can be successfully performed in 99% of patients without peri-procedural stroke or death and is associated with durable symptom resolution in approximately 80% of patients at one year. In these high-risk patients, endovascular therapy for symptomatic VAS appears to be safe and effective at relieving symptoms.

Endovascular Treatment of Bilateral Intracranial Vertebral Artery Dissecting Aneurysms Presenting With Subarachnoid Hemorrhage

2011 ◽  
Vol 70 (suppl_1) ◽  
pp. ons75-ons81 ◽  
Author(s):  
Yong Sam Shin ◽  
Byung Moon Kim ◽  
Se-Hyuk Kim ◽  
Sang Hyun Suh ◽  
Chang Woo Ryu ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Endovascular Treatment ◽  
Vertebral Artery ◽  
Posterior Inferior Cerebellar Artery ◽  
Stent Insertion ◽  
Treatment Methods ◽  
Cerebellar Artery ◽  
Endovascular Methods ◽  
Dissecting Aneurysms

Abstract BACKGROUND: Optimal management of bilateral vertebral artery dissecting aneurysms (bi-VDAs) causing subarachnoid hemorrhage (SAH) remains unclear. OBJECTIVE: To investigate the treatment methods and outcomes of bi-VDA causing SAH. METHODS: Seven patients were treated endovascularly for bi-VDA causing SAH. Treatment methods and outcomes were evaluated retrospectively. RESULTS: Two patients were treated with 2 overlapping stents for both ruptured and unruptured VDAs, 2 with 2 overlapping stents and coiling for ruptured VDA and with conservative treatment for unruptured VDA, 1 with internal trapping (IT) for ruptured VDA and stent-assisted coiling for unruptured VDA, 1 with IT for ruptured VDA and 2 overlapping stents for unruptured VDA, and 1 with IT for ruptured VDA and a single stent for unruptured VDA. None had rebleeding during follow-up (range, 15-48 months). All patients had favorable outcomes (modified Rankin Scale score, 0-2). On follow-up angiography at 6 to 36 months, 9 treated and 2 untreated VDAs revealed stable or improved state, whereas 3 VDAs in 2 patients showed regrowth. Of the 3 recurring VDAs, 1 was initially treated with IT but recurred owing to retrograde flow to the ipsilateral posterior inferior cerebellar artery (PICA), the second was treated with single stent but enlarged, and the last was treated with 2 overlapping stents and coiling but recurred from the remnant sac harboring the PICA origin. All 3 recurred VDAs were retreated with coiling with or without stent insertion. CONCLUSION: Bilateral VDAs presenting with SAH were safely treated with endovascular methods. However, endovascular treatment may be limited for VDAs with PICA origin involvement.

Sign in / Sign up

Export Citation Format

Share Document