Article Test

Background- Ruptured vertebral artery dissecting aneurysms (VADA) should be treated promptly because of the high risk of rebleeding.  However, it is difficult to treat dissecting aneurysm during the acute stage by microsurgery because of high intracranial pressure or brain edema.  Therefore, endovascular treatment of the ruptured VADA may be a better technique. We retrospectively studied the efficacy and outcome of endovascular treatment of ruptured VADA in the acute stage. 

Methods- Nineteen patients with ruptured VADA received endovascular treatment in the acute stage. Among them, 17 were treated by internal trapping of the dissected segment. We performed stent-assisted coiling for a case of VADA in the contralateral hypoplastic VA and a case of bilateral dissection (ruptured VADA of the right VA and dissection of the left VA).

Results- Seven patients (37%) had good recovery, 3 patients (26%) had moderate disability, 3 patients (16%) had severe disability, one patient (5%) entered a persistent vegetative state, and 3 patients (16%) died. There was no recurrent hemorrhage after endovascular treatment, but complications related to the endovascular procedures occurred in 3 patients.

Conclusion- Endovascular treatment of ruptured VADA in the acute stage appears to be safe and effective.