Abstract:Objective: To investigate the treatment method for vertebral artery dissecting aneurysms keeping the parent artery patent and the efficacy.
Methods: The clinical data of 28 patients with vertebral artery dissecting aneurysms treated with the parent artery patent from January 2013 to October 2018 were retrospectively analyzed.
Results: Of the 28 patients, 12 cases had unruptured lesions and 16 cases had ruptured lesions, with an average age of (51.8±7.5) years. The surgical technical success rate of the 28 patients was 100%. Five patients with unruptured aneurysms were implanted with two or more stents. Immediate postoperative angiography showed that the contrast agent was retained in the aneurysm. The follow-up angiography showed that the aneurysms disappeared or diminished, with the Raymond grade I in 3 cases (3/5) and grade II in 2 cases (3/5). The other 23 patients were treated with double overlapping stent-assisted coil embolization. Immediate postoperative angiography showed Raymond grade I in 11 cases (11/23), grade II in 5 cases (5/23) and grade III in 7 cases (7/23), of whom, 19 cases (19/23) were followed up for (14.5±7.9) months, and the follow-up imaging results showed Raymond grade I in 16 cases (16/19), grade II 3 cases (3/19) and no grade III lesion. In the 16 patients with ruptured lesions, 2 cases developed in-stent thrombosis or perforating branch events, which were resolved after thrombolytic therapy. The prognostic mRS score ≤2 in 27 patients and ≥3 in one patient.
Conclusion: Leaving the parent artery patent, multiple stent placement or multiple stent assisted coil embolization can achieve good clinical results in treatment of vertebral artery dissection aneurysms.