scholarly journals A Case of Migration of Pipeline Embolization Device Causing Rupture during Treatment of an Unruptured Vertebral Artery Dissecting Aneurysm

2021 ◽  
Vol 27 (2) ◽  
pp. 110-113
Author(s):  
Sung Ho Kim ◽  
Dong Kyu Yeo ◽  
Gwang Soo Lee
Keyword(s):  
Vertebral Artery ◽  
Intracranial Aneurysms ◽  
Rare Complication ◽  
Stent Migration ◽  
Dissecting Aneurysm ◽  
Potential Complication ◽  
Pipeline Embolization Device ◽  
New Treatment ◽  
Vertebral Artery Dissecting Aneurysm ◽  
Perforating Arteries

Endoluminal reconstruction of an intracranial aneurysm using flow-diverting devices, such as the pipeline embolization device (PED), is a new treatment modality with good clinical outcomes. The device was originally indicated for challenging cases, such as wide-necked large or giant aneurysms, and is gaining popularity as a reliable treatment for nearly all intracranial aneurysms. The overall complication rate of flow-diverting devices use is 17.0%, including occlusion of side-branching or perforating arteries, rerupture of the aneurysm, in-stent thrombosis, and, rarely, stent migration. We report a rare complication of the PED: delayed migration of the PED after successful stent implantation during treatment of an unruptured vertebral artery dissecting aneurysm, which resulted in rupture of the aneurysm. Further, we discuss technical steps that can be taken to prevent this potential complication.

scholarly journals Advancing Marksman into contralateral vertebral artery in the treatment of intradural vertebral artery dissecting aneurysm with Pipeline

2016 ◽  
Vol 23 (2) ◽  
pp. 151-153
Author(s):  
Yupeng Zhang ◽  
Shikai Liang ◽  
Chuhan Jiang
Keyword(s):  
Neck Pain ◽  
Vertebral Artery ◽  
Clinical Course ◽  
Dissecting Aneurysm ◽  
Pipeline Embolization Device ◽  
Vertebral Arteries ◽  
Vertebral Artery Dissecting Aneurysm ◽  
Reconstructive Techniques ◽  
Flow Diverters ◽  
Dissecting Aneurysms

Unruptured vertebral arteries dissecting aneurysms have a benign clinical course. The most common symptoms compromise headache, neck pain, dizziness and vomiting. The optimal endovascular treatment option remains controversial. Reconstructive techniques have many advantages over deconstructive ones since the advent of flow diverters such as the Pipeline embolization device (PED). Here, we present a case successfully treated with a PED through a combination of the radial access and advancement of the Marksman catheter into the contralateral vertebral artery due to the special angio-architecture of the patient.

Republished: Novel balloon application for rescue and realignment of a proximal end migrated pipeline flex embolization device into the aneurysmal sac: complication management

2016 ◽  
Vol 9 (1) ◽  
pp. e4-e4 ◽  
Author(s):  
Mario Martínez-Galdámez ◽  
Joaquin Ortega-Quintanilla ◽  
Antonio Hermosín ◽  
Eduardo Crespo-Vallejo ◽  
Juan José Ailagas ◽  
...  
Keyword(s):  
Intracranial Aneurysms ◽  
Stent Migration ◽  
Complication Management ◽  
Potential Complication ◽  
Luminal Diameter ◽  
Pipeline Embolization Device ◽  
Balloon Technique ◽  
Large Aneurysm ◽  
Flow Diverting Stent

The pipeline embolization device (PED) has become a routine firstline option for the treatment of an increasing population of intracranial aneurysms at many neurovascular centers. Intraprocedural complications during PED deployment, or complications associated with migration of the device, are rarely reported problems. Significant mismatch in luminal diameter between the inflow vessel and the outflow vessel or excessive dragging–stretching of the PED have been related to ‘watermelon seed’ or ‘accordion’ effects, respectively, resulting in stent migration. Here we present a novel balloon technique that was successfully used to realign an in situ flow diverting stent that had prolapsed into a large aneurysm. This represents a useful salvage technique and should be considered when encountering this potential complication.

scholarly journals Vertebral Artery Dissecting Aneurysm With Cushing's Syndrome

2010 ◽  
Vol 50 (4) ◽  
pp. 313-315 ◽  
Author(s):  
Masayasu KATO ◽  
Yoshitaka TANAKA ◽  
Tatsuya KURODA ◽  
Toshihiko NAKASHIMA ◽  
Tatsuaki HATTORI
Keyword(s):  
Vertebral Artery ◽  
Cushing’S Syndrome ◽  
Cushing's Syndrome ◽  
Dissecting Aneurysm ◽  
Vertebral Artery Dissecting Aneurysm

Clinical and radiological risk factors for rupture of vertebral artery dissecting aneurysm: significance of the stagnation sign

2021 ◽  
pp. 1-6
Keyword(s):  
Risk Factors ◽  
Vertebral Artery ◽  
Posterior Inferior Cerebellar Artery ◽  
Significant Risk ◽  
Multivariate Logistic Regression Analysis ◽  
Significant Risk Factor ◽  
Tertiary Hospital ◽  
Dissecting Aneurysm ◽  
Irregular Surface ◽  
Vertebral Artery Dissecting Aneurysm

OBJECTIVE The aim of this study was to investigate the clinical and radiological factors associated with the rupture of a vertebral artery dissecting aneurysm (VADA) and to evaluate whether the stagnation sign is a significant risk factor for rupture of VADA. METHODS Clinical and radiological variables of 117 VADAs treated in a tertiary hospital from September 2008 to December 2020 were retrospectively reviewed. The stagnation sign is defined as the finding of contrast agent remaining in the lesion until the venous phase of angiography. Univariate and multivariate analyses were executed to reveal the associations between rupture status and VADA characteristics. RESULTS The rate of ruptured VADAs was 29.1% (34 of 117) and the stagnation sign was observed in 39.3% (46 of 117). Fusiform shape (OR 5.105, 95% CI 1.591–16.383, p = 0.006), irregular surface (OR 4.200, 95% CI 1.412–12.495, p = 0.010), posterior inferior cerebellar artery (PICA) involvement (OR 3.788, 95% CI 1.288–11.136, p = 0.016), and the stagnation sign (OR = 3.317, 95% CI 1.131–9.732, p = 0.029) were significantly related to rupture of VADA in multivariate logistic regression analysis. CONCLUSIONS This study showed that fusiform shape, irregular surface, PICA involvement, and the stagnation sign may be independent risk factors for the rupture of VADA. Therefore, when the potential risk factors are observed in unruptured VADA, more aggressive treatment rather than follow-up or medical therapy may be considered.

scholarly journals Proximal Flow Arrest With Temporary Subclavian Steal for Internal Trapping of a Ruptured Vertebral Artery Dissecting Aneurysm

2007 ◽  
Vol 47 (1) ◽  
pp. 18-21 ◽  
Author(s):  
Takehiro UDA ◽  
Keiji MURATA ◽  
Kazuhito NAKAMURA ◽  
Tsutomu ICHINOSE ◽  
Taro KUSAKABE ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Dissecting Aneurysm ◽  
Subclavian Steal ◽  
Vertebral Artery Dissecting Aneurysm

scholarly journals Vertebral artery dissecting aneurysm associated with abducens nerve palsy: a report of 7 cases and review of literature

Nosotchu ◽  
2013 ◽  
Vol 35 (1) ◽  
pp. 12-19
Author(s):  
Yui Mano ◽  
Mizuho Inoue ◽  
Ayumi Narisawa ◽  
Shinya Koyama ◽  
Hiroyuki Kon ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Nerve Palsy ◽  
Abducens Nerve ◽  
Dissecting Aneurysm ◽  
Abducens Nerve Palsy ◽  
Review Of Literature ◽  
Vertebral Artery Dissecting Aneurysm
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