scholarly journals A case of multiple stent-assisted coil embolization by LVIS stent for a ruptured basilar artery dissecting aneurysm

Nosotchu ◽  
2021 ◽  
Author(s):  
Shinichiro Yoshida ◽  
Hiroaki Hanayama ◽  
Ikuya Yamaura ◽  
Hiroaki Minami ◽  
Yasuhisa Yoshida
Keyword(s):  
Basilar Artery ◽  
Coil Embolization ◽  
Dissecting Aneurysm

scholarly journals Endovascular treatment of a basilar artery dissecting aneurysm

2007 ◽  
Vol 65 (4a) ◽  
pp. 1012-1014 ◽  
Author(s):  
Cristiane Borges Patroclo ◽  
Paulo Puglia Jr ◽  
Claudia da Costa Leite ◽  
Fabio Iuji Yamamoto ◽  
Jovana Gobbi Marchesi Ciríaco ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Effective Treatment ◽  
Basilar Artery ◽  
Coil Embolization ◽  
Clinical Course ◽  
Dissecting Aneurysm ◽  
High Morbidity ◽  
Hemorrhagic Complications ◽  
Clinical And Radiological Results ◽  
Dissecting Aneurysms

Basilar artery (BA) dissecting aneurysms pose difficulties to treatment because both bleeding and thrombosis can happen in the same patient, clinical course is unpredictable and high morbidity is usual. We report the case of a 37-year-old woman with a BA aneurysm probably caused by arterial dissection, presenting embolic and hemorrhagic complications. The aneurysm was submitted to endovascular treatment with stenting and coil embolization. Clinical and radiological results were excellent and no complications were observed, suggesting that BA stenting and coil embolization may be a safe and effective treatment for this condition.

scholarly journals Overlapping Stent Placement with Coil Embolization for Ruptured Growing Basilar Artery Dissecting Aneurysm: A Case Report

2018 ◽  
Vol 12 (6) ◽  
pp. 281-286
Author(s):  
Satoshi Inoue ◽  
Atsushi Fujita ◽  
Takashi Mizowaki ◽  
Te Jin Lee ◽  
Ryuichi Kuroda ◽  
...  
Keyword(s):  
Case Report ◽  
Basilar Artery ◽  
Stent Placement ◽  
Coil Embolization ◽  
Dissecting Aneurysm

scholarly journals Clinical Results and Pathological Findings of Stent-Assisted Coil Embolization for Basilar Artery Trunk Dissecting Aneurysms

2003 ◽  
Vol 9 (1_suppl) ◽  
pp. 95-99 ◽  
Author(s):  
H. Nagashima ◽  
K. Hongo ◽  
Y. Matsumoto ◽  
F. Oya ◽  
S. Kobayashi ◽  
...  
Keyword(s):  
Basilar Artery ◽  
Coil Embolization ◽  
Pathological Finding ◽  
Clinical Results ◽  
Dissecting Aneurysm ◽  
Parent Artery ◽  
Thromboembolic Complications ◽  
Pathological Findings ◽  
Effective Treatment Option ◽  
Dissecting Aneurysms

Stent-assisted coil embolization is a new method for treating dissecting or fusiform aneurysm, especially the aneurysms arising from the basilar artery trunk or dominant vertebral artery. At present, this technique is considered as an effective treatment option to obliterate such aneurysm keeping the parent artery patent. Several authors reported the effectiveness and excellent radiological result of this treatment, but fewer reports focus on the limitations of this technique. We treated two patients with a basilar artery trunk dissecting aneurysm with this technique. Transient ischemic symptoms were observed in one patient and haemorrhagic and thromboembolic complications were observed the other. We lost the latter patient due to postoperative complications, and the pathological finding was achieved by autopsy. We report the clinical and pathological findings in the two cases and investigate the efficacy and limitations of this technique.

scholarly journals Dissecting Aneurysm of the Basilar Arterial Trunk Presenting with Pontine Infarction

2007 ◽  
Vol 13 (4) ◽  
pp. 381-384 ◽  
Author(s):  
Y.-G. Jang ◽  
C.W. Ryu ◽  
J.S. Kim ◽  
E.Y. Cha ◽  
H.W. Pyun ◽  
...  
Keyword(s):  
Basilar Artery ◽  
Dissecting Aneurysm ◽  
Parent Artery ◽  
High Morbidity ◽  
Complete Disappearance ◽  
Collateral Flow ◽  
Arterial Trunk ◽  
Pontine Infarction ◽  
Diseased Segment ◽  
Procedural Complication

Dissecting basilar aneurysms have rarely been reported but are associated with high morbidity and mortality. Therefore, controversy exists as to the proper management of such lesions because their natural course is not well understood. We describe a 50-year-old man with a dissecting aneurysm involving the lower basilar trunk who presented with pontine infarction corresponding to the aneurysmal sac location. We obliterated the dissecting basilar aneurysm by coil embolization of the aneurysmal sac as well as the diseased segment of the basilar trunk after confirmation of collateral filling of the basilar artery through the posterior communicating artery. The patient recovered without any procedural complication. Eight month follow-up revealed complete disappearance of the aneurysm without symptom recurrence together with preservation of collateral flow in the distal basilar artery. Obliteration of the parent artery as well as the aneurysmal sac with coils could be considered in a lower basilar aneurysm of a dissecting nature.

A fatal, chronically growing basilar artery: a new type of dissecting aneurysm

1996 ◽  
Vol 84 (6) ◽  
pp. 962-971 ◽  
Author(s):  
Tohru Mizutani
Keyword(s):  
Mr Imaging ◽  
Basilar Artery ◽  
Dissecting Aneurysm ◽  
Neurological Deficits ◽  
Vertebrobasilar Insufficiency ◽  
Content Type ◽  
Asymptomatic Patients ◽  
Basilar Arteries ◽  
Fine Print

✓ A long-term follow-up study (minimum duration 2 years) was made of 13 patients with tortuous dilated basilar arteries. Of these, five patients had symptoms related to the presence of such arteries. Symptoms present at a very early stage included vertebrobasilar insufficiency in two patients, brainstem infarction in two patients, and left hemifacial spasm in one patient. Initial magnetic resonance (MR) imaging in serial slices of basilar arteries obtained from the five symptomatic patients showed an intimal flap or a subadventitial hematoma, both of which are characteristic of a dissecting aneurysm. In contrast, the basilar arteries in the eight asymptomatic patients did not show particular findings and they remained clinically and radiologically silent during the follow-up period. All of the lesions in the five symptomatic patients gradually grew to fantastic sizes, with progressive deterioration of the related clinical symptoms. Dilation of the basilar artery was consistent with hemorrhage into the “pseudolumen” within the laminated thrombus, which was confirmed by MR imaging studies. Of the five symptomatic patients studied, two died of fatal subarachnoid hemorrhage (SAH) and two of brainstem compression; the fifth patient remains alive without neurological deficits. In the three patients who underwent autopsy, a definite macroscopic double lumen was observed in both the proximal and distal ends of the aneurysms within the layer of the thickening intima. Microscopically, multiple mural dissections, fragmentation of internal elastic lamina (IEL), and degeneration of media were diffusely observed in the remarkably extended wall of the aneurysms. The substantial mechanism of pathogenesis and enlargement in the symptomatic, highly tortuous dilated artery might initially be macroscopic dissection within a thickening intima and subsequent repetitive hemorrhaging within a laminated thrombus in the pseudolumen combined with microscopic multiple mural dissections on the basis of a weakened IEL. The authors note and caution that symptomatic, tortuous dilated basilar arteries cannot be overlooked because they include a group of malignant arteries that may grow rapidly, resulting in a fatal course.

scholarly journals Dissecting Aneurysm of the Vertebro-basilar Artery

1984 ◽  
Vol 24 (5) ◽  
pp. 343-348 ◽  
Author(s):  
Motoharu YOKOYAMA ◽  
Isamu KURITA ◽  
Mitsunari YAMASHITA ◽  
Goro UEMURA ◽  
Yasuji YOSHIDA ◽  
...  
Keyword(s):  
Basilar Artery ◽  
Dissecting Aneurysm

Stent-assisted coil embolization followed by a stent-within-a-stent technique for ruptured dissecting aneurysms of the intracranial vertebrobasilar artery

2009 ◽  
Vol 111 (1) ◽  
pp. 48-52 ◽  
Author(s):  
Sang Hyun Suh ◽  
Byung Moon Kim ◽  
Sung Il Park ◽  
Dong Ik Kim ◽  
Yong Sam Shin ◽  
...  
Keyword(s):  
Coil Embolization ◽  
Therapeutic Option ◽  
Direct Consequence ◽  
Treatment Method ◽  
Dissecting Aneurysm ◽  
High Rate ◽  
Parent Artery ◽  
Vertebrobasilar Artery ◽  
Complete Obliteration

Object A ruptured dissecting aneurysm of the vertebrobasilar artery (VBA-DA) is a well-known cause of acute subarachnoid hemorrhage (SAH) with a high rate of early rebleeding. Internal trapping of the parent artery, including the dissected segment, is one of the most reliable techniques to prevent rebleeding. However, for a ruptured VBA-DA not suitable for internal trapping, the optimal treatment method has not been well established. The authors describe their experience in treating ruptured VBA-DAs not amenable to internal trapping of the parent artery with stent-assisted coil embolization (SAC) followed by a stent-within-a-stent (SWS) technique. Methods Eleven patients—6 men and 5 women with a mean age of 48 years and each with a ruptured VBA-DA not amenable to internal trapping of the parent artery—underwent an SAC-SWS between November 2005 and October 2007. The feasibility and clinical and angiographic outcomes of this combined procedure were retrospectively evaluated. Results The SAC-SWS was successful without any treatment-related complications in all 11 patients. Immediate posttreatment angiograms revealed complete obliteration of the DA sac in 3 patients, near-complete obliteration in 7, and partial obliteration in 1. One patient died as a direct consequence of the initial SAH. All 10 surviving patients had excellent clinical outcomes (Glasgow Outcome Scale Score 5) without posttreatment rebleeding during a follow-up period of 8–24 months (mean follow-up 15 months). Angiographic follow-up at 6–12 months after treatment was possible at least once in all surviving patients. Nine VBA-DAs showed complete obliteration; the other aneurysm, which had appeared partially obliterated immediately after treatment, demonstrated progressive obliteration on 2 consecutive follow-up angiography studies. There was no in-stent stenosis or occlusion of the branch or perforating vessels. Conclusions The SAC-SWS technique seems to be a feasible and effective reconstructive treatment option for a ruptured VBA-DA. The technique may be considered as an alternative therapeutic option in selected patients with ruptured VBA-DAs unsuitable for internal trapping of the parent artery.

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