Endovascular treatment of isolated dissecting XXXX .

@entity129 @entity1 @entity16 @entity51 @entity439 @entity5487 @entity432
BACKGROUND AND PURPOSE: Isolated dissecting @entity5487 (PICA) carry a high risk of rebleeding with an associated increased mortality rate. Although rare, they present a therapeutic challenge. Surgical treatment carries a significant risk of @entity16 , predominantly lower @entity129 because of the close relationship of the @entity439 with the brain stem and cranial nerves. The purpose of this article is to show that endovascular treatment of dissecting @entity439 of the PICA can be effective and can allow the @entity1 to avoid the complications associated with surgery. METHODS: Six @entity1 (age range, 28-70 years) with dissecting @entity439 of the PICA were treated at our center by endovascular occlusion with Guglielmi detachable coils or glue and followed for up to 30 months. Inclusion of @entity1 in the study was based on careful angiographic assessment of the vascular anatomy and collateral supply of the posterior fossa. When on the basis of the anatomy, potential lack of sufficient collaterals was suggested, a test occlusion was performed to determine the feasibility of an endovascular approach. Four additional cases, which have been described in the literature, were included in the analysis of results. RESULTS: In all @entity1 , the @entity439 was successfully occluded with no apparent procedure-related complications. Follow-up studies showed stable and complete occlusion of the @entity439 in all @entity1 with no long-term @entity51 . CONCLUSIONS: Endovascular treatment by @entity439 and parent @entity432 is a relatively safe and reliable alternative to surgery for isolated dissecting @entity439 of the PICA.
