scholarly journals Extracranial vertebral artery rupture likely secondary to “cupping therapy” superimposed on spontaneous dissection

2016 ◽  
Vol 22 (6) ◽  
pp. 728-731 ◽  
Author(s):  
Jae Young Choi ◽  
Chae Wook Huh ◽  
Chang Hwa Choi ◽  
Jae Il Lee
Keyword(s):  
Endovascular Treatment ◽  
Vertebral Artery ◽  
Rare Case ◽  
Cupping Therapy ◽  
Oriental Medicine ◽  
Common Location ◽  
Posterior Neck ◽  
Extracranial Vertebral Artery ◽  
Spontaneous Dissection

The extracranial vertebral artery (VA) is vulnerable to dissection and the V3 segment is the most common location for dissection. Dissection accounts for about 2% of all ischemic strokes and can occur after trauma or chiropractic neck maneuvers. We report an extremely rare case of spontaneous extracranial VA dissection presenting with posterior neck hematoma aggravated after cupping therapy, a treatment in traditional Oriental medicine. We treated the patient successfully by endovascular treatment without any complication.

Embolic Cerebellar Infarction Caused by Spontaneous Dissection of the Extracranial Vertebral Artery. Two Case Reports.

2000 ◽  
Vol 40 (6) ◽  
pp. 310-314 ◽  
Author(s):  
Masaki KOMIYAMA ◽  
Toshie MORIKAWA ◽  
Hideki NAKAJIMA ◽  
Misao NISHIKAWA ◽  
Toshihiro YASUI
Keyword(s):  
Vertebral Artery ◽  
Case Reports ◽  
Cerebellar Infarction ◽  
Extracranial Vertebral Artery ◽  
Spontaneous Dissection

An unusual case of a giant extracranial vertebral artery aneurysm

Vascular ◽  
2019 ◽  
Vol 27 (4) ◽  
pp. 427-429 ◽  
Author(s):  
Abd Elaziz A Suliman ◽  
Hytham KS Hamid ◽  
Salwa O Mekki
Keyword(s):  
Vertebral Artery ◽  
Symptomatic Relief ◽  
Artery Aneurysm ◽  
Giant Aneurysm ◽  
Mass Effect ◽  
Posterior Neck ◽  
Post Traumatic ◽  
Extracranial Vertebral Artery ◽  
The Right ◽  
Significant Mass Effect

Objective Extracranial vertebral artery (VA) aneurysms are rare and are often post-traumatic secondary to penetrating or blunt injuries. Primary extracranial VA aneurysms are far less common. Most of these lesions are located in the proximal (V1) and middle (V2) segments of the VA. Method We report an extremely rare case of a giant aneurysm of the extracranial vertebral artery in a 50-year-old woman who presented with a right posterior neck swelling, headache and pain at the site of the mass. Angiography confirmed aneurysm of V3 segment of the right VA. Treatment included ligation of the artery and aneurysmectomy. Result Magnetic resonance angiography at 12 months showed obliterated proximal segment of the right VA with no obvious flow distally. Conclusion Aneurysms of the extracranial VA are clinically relevant because of the associated risks of rupture and distal embolization. For patients with rupture, pending rupture or a significant mass effect due to a giant lesion, surgery is the treatment modality of choice to attain symptomatic relief.

Advances and Innovations in Revascularization of Extracranial Vertebral Artery

Neurosurgery ◽  
2014 ◽  
Vol 74 (suppl_1) ◽  
pp. S102-S115 ◽  
Author(s):  
Leonardo B. C. Brasiliense ◽  
Felipe C. Albuquerque ◽  
Robert F. Spetzler ◽  
Ricardo A. Hanel
Keyword(s):  
Carotid Artery ◽  
Endovascular Treatment ◽  
Vertebral Artery ◽  
Treatment Options ◽  
Bare Metal Stents ◽  
Atherosclerotic Disease ◽  
Metal Stents ◽  
General Tendency ◽  
Endovascular Revascularization ◽  
Extracranial Vertebral Artery

Abstract Revascularization of the extracranial vertebral artery has evolved significantly since the adoption of endovascular techniques. The current neurosurgical armamentarium includes microsurgical and endovascular approaches. The indications for each treatment modality, however, still need to be further delineated. In contrast to carotid artery endarterectomy and carotid artery angioplasty/stenting, there is limited comparative evidence on the efficacy of medical, open, and endovascular treatment of atherosclerotic disease of the extracranial vertebral artery. More recently, drug-eluting stents have gained momentum after high rates of in-stent restenosis have been reported with bare metal stents placed in the vertebral artery. In this article, we discuss the indications, clinical assessment, and surgical nuances of microsurgical and endovascular revascularization for atherosclerotic disease of the extracranial vertebral artery. Despite a general tendency to consider endovascular treatment in the majority of patients, ultimately, open and endovascular revascularization of extracranial vertebral artery should be regarded as complementary therapies and both treatment options need to be discussed in selected patients.

scholarly journals Stent-Assisted Angioplasty of Spontaneous Bilateral Extracranial Vertebral Dissections under Intravascular Ultrasound Guidance

2018 ◽  
Vol 10 (3) ◽  
pp. 314-321 ◽  
Author(s):  
Won-Bae Seung
Keyword(s):  
Neck Pain ◽  
Vertebral Artery ◽  
Intravascular Ultrasound ◽  
Stent Placement ◽  
Ultrasound Guidance ◽  
Stent Angioplasty ◽  
True Lumen ◽  
Feasible Method ◽  
Posterior Neck ◽  
Extracranial Vertebral Artery

The authors here report a case of stent-assisted angioplasty under intravascular ultrasound (IVUS) guidance for the treatment of spontaneous bilateral extracranial vertebral artery (VA) dissection. A 47-year-old woman presented with spontaneous severe posterior neck pain. Examinations revealed bilateral extracranial VA dissection, which was thought to be the reason for her symptom. However, since the pain was gradually worsening even after sufficient medical treatment, she underwent stent angioplasty under IVUS guidance, following which her symptoms improved. We propose that stent placement under IVUS guidance is a safe and feasible method for treating extracranial VA dissections. Since the intravascular environment is seen in real time with IVUS, this technique is useful for confirming a true lumen and evaluating appropriate stent apposition. More clinical experience with this technique is required and mandatory, and devices with smaller diameters with improved trackability are essential for further introduction of IVUS into the field of endovascular neurosurgery.

scholarly journals Anatomically Based Approach for Endovascular Treatment of Vertebro-Vertebral Arteriovenous Fistula

2014 ◽  
Vol 20 (6) ◽  
pp. 766-773 ◽  
Author(s):  
Chih-Hua Yeh ◽  
Yao-Liang Chen ◽  
Yi-Ming Wu ◽  
Yu-Chieh Huang ◽  
Ho-Fai Wong
Keyword(s):  
Endovascular Treatment ◽  
Vertebral Artery ◽  
Arteriovenous Fistula ◽  
Covered Stent ◽  
Treatment Modalities ◽  
Covered Stents ◽  
Vertebral Arteriovenous Fistula ◽  
Fistula Recurrence ◽  
Detachable Coils ◽  
Extracranial Vertebral Artery

Vertebro-vertebral arteriovenous fistula (VV-AVF) is a rare vascular disorder with an abnormal high-flow shunt between the extracranial vertebral artery (VA), its muscular or radicular branches and an adjacent vein. To date, there are no guidelines on the best treatment for VV-AVF. We present our experience of VV-AVF treatment with covered stents in three patients and detachable coils in two patients. One patient with fistula at the V3 segment had rapid fistula recurrence one week after covered stent treatment. The possible causes of failed treatment in this patient are discussed. The currently available treatment modalities for VV-AVF are also summarized after a literature review. At the end of this article, we propose a new concept of anatomically based approach for endovascular treatment of VV-AVF. Fistula in the V1-2 segments of vertebral artery could be treated safely and effectively by covered stent with the benefit of preserving VA patency. Embolization with variable embolizers should be considered first for fistula in the V3 segment because of the tortuous course and flexibility of the VA in this segment.

Intravascular ultrasonography-guided stent angioplasty of an extracranial vertebral artery dissection

2008 ◽  
Vol 109 (6) ◽  
pp. 1113-1118 ◽  
Author(s):  
Won-Ki Yoon ◽  
Young-Woo Kim ◽  
Sang-Don Kim ◽  
Ik-Seong Park ◽  
Min-Woo Baik ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Coil Embolization ◽  
Posterior Inferior Cerebellar Artery ◽  
Vertebral Artery Dissection ◽  
Artery Dissection ◽  
Intravascular Ultrasonography ◽  
Stent Angioplasty ◽  
Posterior Neck ◽  
Extracranial Vertebral Artery ◽  
The Right

The authors report on a case of intravascular ultrasonography (IVUS)-guided stent angioplasty for iatrogenic extracranial vertebral artery (VA) dissection in a 49-year-old man after coil embolization for an unruptured aneurysm of the right posterior inferior cerebellar artery. Insignificant dissections occurred during the procedure. Postoperatively, the patient experienced gradually worsening posterior neck pain and headache, and follow-up angiography 8 months after the coil embolization revealed expansion of the dissection. The patient underwent stent angioplasty with IVUS guidance and his symptoms improved. To the authors' knowledge, this is the first report of IVUS-guided stent angioplasty of an extracranial VA dissection. It was safe and feasible to treat extracranial VA dissections with stent placement under IVUS guidance. Intravascular environments are in real time with IVUS, and this technique is useful in the confirmation of a true lumen and evaluation of appropriate stent apposition. More clinical experience with this technique is necessary and mandatory, and devices with smaller diameters with improved trackability are essential for further introduction of IVUS into the field of endovascular neurosurgery.

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