Long-term follow-up study of 35 cases after endovascular treatment for vertebrobasilar dissecting XXXX .

@entity1 @entity385 @entity63 @entity439 @entity715 @entity204 @entity1779 @entity1756
OBJECTIVE: Vertebrobasilar dissecting @entity439 (VBDA) management is challenging despite the availability of multiple treatment strategies. We reviewed our experiences using endovascular treatment for VBDA @entity1 to assess the efficacy and safety of several VBDA treatment strategies. METHODS: Assisted by intra-arterial digital subtraction angiography, 35 @entity1 in our hospital were treated using various VBDA treatment strategies, including stent-assisted coil embolization (20 @entity1 ), placement of single or multiple overlapping stents (5 @entity1 ) or coil embolization combined with proximal coil trapping of the dissected segment of the parent artery (CE+PT; 10 @entity1 ). We retrospectively reviewed the perioperative records of all 35 @entity1 and the post-procedure angiographic and clinical outcomes of 31 available @entity1 . RESULTS: Of the 25 cases with ruptured VBDAs, 14 underwent stent-assisted coil embolization, 2 underwent multiple overlapping stent placement and 9 underwent CE+PT. Perioperative complications occurred in four cases (16.0%), including one @entity1756 and one parent artery @entity715 during the procedure and two incidences of @entity63 after the procedure. Clinical outcome evaluations were performed using the Modified Rankin Scale and resulted in the following scores: 0-2 for 22 @entity1 (22/25, 88.0%), 5 for one @entity1 (1/25, 4.0%) and 6 for two @entity1 (2/25, 8.0%). No @entity1779 events or @entity204 occurred during the follow-up period. Of the 10 cases with unruptured VBDAs, six underwent stent-assisted coil embolization, three underwent single or multiple overlapping stent placement and one @entity1 underwent CE+PT. All 10 of the @entity1 with unruptured VBDAs had favorable clinical and radiologic outcomes without procedure-related complications. CONCLUSIONS: For @entity1 with ruptured VBDAs, the complication rate associated with endovascular treatment is acceptable. CE+PT is better than stent coiling in preventing @entity439 , but is associated with a high incidence of @entity385 . For unruptured VBDAs, endovascular treatment is associated with good clinical outcome without perioperative complications, including rerupture and @entity385 . However, the high postoperative recurrent @entity439 risk suggests the necessity of long-term angiographic follow-up monitoring of VBDA @entity1 who undergo endovascular treatments.
