Comparison of Parent Artery Occlusion and Stent-Assisted Treatments in Ruptured Vertebral Artery Dissecting Aneurysms.
Humans
Infant
Vertebral Artery
/ diagnostic imaging
Treatment Outcome
Vertebral Artery Dissection
/ diagnostic imaging
Stents
Embolization, Therapeutic
/ methods
Retrospective Studies
Endovascular Procedures
/ methods
Craniocerebral Trauma
/ therapy
Aortic Dissection
Aneurysm, Ruptured
/ diagnostic imaging
Intracranial Aneurysm
/ therapy
Parent artery occlusion
Posterior inferior cerebellar artery
Risk factor
Ruptured vertebral artery dissecting aneurysm
Stent
Journal
World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275
Informations de publication
Date de publication:
Nov 2022
Nov 2022
Historique:
received:
10
04
2022
revised:
08
08
2022
accepted:
09
08
2022
pubmed:
18
8
2022
medline:
18
2
2023
entrez:
17
8
2022
Statut:
ppublish
Résumé
To assess clinical outcomes of ruptured vertebral artery dissecting aneurysms, focusing on comparing parent artery occlusion (PAO) with stent-assisted treatments, and to identify risk factors for unfavorable outcomes and postprocedural complications. This retrospective review included 36 ruptured vertebral artery dissecting aneurysms treated between February 2009 and April 2020. Treatment modalities included PAO without stent and stent-assisted treatments. Stent-assisted treatments included PAO with posterior inferior cerebellar artery (PICA) stenting and stent-assisted coiling. Univariate and multivariate analyses were conducted to evaluate risk factors for unfavorable outcomes and postprocedural complications. Patients were treated with PAO only (24, 66.7%), PAO with PICA stenting (4, 11.1%), and PAO with stent-assisted coiling (8, 22.2%). There were only fusiform aneurysms with PICA involvement in the PAO with PICA stenting group. In the stent-assisted coiling group, 4 aneurysms incorporated PICA, and 4 aneurysms involved dominant vertebral artery. Old age (odds ratio [OR] = 1.25, 95% confidence interval [CI] = 1.01-1.56, P = 0.044) and poor Hunt-Hess grade (OR = 537.99, 95% CI = 6.73-42994.1, P = 0.005) were significantly associated with unfavorable clinical outcomes after a mean follow-up of 37.5 ± 32.8 months. Fusiform dilatation shape (OR = 15.97, 95% CI = 1.52-167.38, P = 0.021) and PICA involvement (OR = 13.71, 95% CI = 1.29-145.89, P = 0.030) were independent risk factors for ischemic complications. Unfavorable clinical outcomes were significantly related to old age and poor Hunt-Hess grade. There were no significant differences between treatment groups in clinical outcomes or ischemic complications. Stent-assisted treatments might be effective and safe methods for ruptured vertebral artery dissecting aneurysms.
Identifiants
pubmed: 35977685
pii: S1878-8750(22)01146-9
doi: 10.1016/j.wneu.2022.08.047
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e533-e540Informations de copyright
Copyright © 2022 Elsevier Inc. All rights reserved.