Endovascular reconstruction of unruptured intradural vertebral artery dissecting aneurysms with the Pipeline embolization device
Authors
Kuhn, Anna L.Kan, Peter
Massi, Francesca
Lozano, Juan Diego
Hou, Samuel Y.
Howk, Mary
Gounis, Matthew J.
Wakhloo, Ajay K.
Puri, Ajit S.
UMass Chan Affiliations
Department of Biochemistry and Molecular PharmacologyNew England Center for Stroke Research
Department of Radiology
Document Type
Journal ArticlePublication Date
2016-10-01Keywords
AneurysmDissection
Flow Diverter
Intervention
Cardiovascular Diseases
Nervous System Diseases
Neurology
Radiology
Surgery
Metadata
Show full item recordAbstract
BACKGROUND: Dissecting aneurysms of the vertebral artery (VA) are difficult to treat using current surgical and endovascular techniques. OBJECTIVE: To analyze retrospectively the efficacy and safety of flow diverters in the treatment of dissecting aneurysms of the vertebral artery. METHODS: We identified six patients with six unruptured VA dissecting aneurysms either arising from the V4 or V3-V4 junction that were treated with the Pipeline embolization device (PED) at our institution between July 2012 and February 2015. Among other parameters, technical feasibility of the procedure, procedure-related complications, angiographic results, and clinical outcome were evaluated. RESULTS: PED placement was achieved in all cases and immediate angiography follow-up demonstrated intra-aneurysmal contrast stasis with parent artery preservation. A temporary episode of dysarthria was noted in one patient. Major procedure-related complications were not observed. The 6-month follow-up (n=6) demonstrated complete/near-complete aneurysm obliteration in five patients and partial obliteration in one. At the 1-year follow-up (n=5) stable complete aneurysm occlusion was seen in two patients. Two cases showed progression from near complete occlusion and partial occlusion at 6 months to complete occlusion and near complete occlusion. One cases showed unchanged near complete occlusion. No aneurysmal bleeding, in-stent stenosis or thromboembolic complication was seen. National Institutes of Health Stroke Scale and modified Rankin scale scores remained unchanged from admission to discharge. CONCLUSIONS: Our preliminary experience with the use of PED for the treatment of intradural VA dissecting aneurysms shows promising short-term results, making this technique a feasible and safe treatment option in patients suitable for this approach. However, long-term and larger cohort studies are needed to validate these results.Source
J Neurointerv Surg. 2016 Oct;8(10):1048-51. Epub 2015 Nov 6. Link to article on publisher's siteDOI
10.1136/neurintsurg-2015-012028Permanent Link to this Item
http://hdl.handle.net/20.500.14038/48115PubMed ID
26546600Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1136/neurintsurg-2015-012028