Endovascular Treatment of Intracranial Vertebral Artery Dissection.
dissecting aneurysm
dissection
endovascular treatment
vertebral artery
Journal
Journal of neuroendovascular therapy
ISSN: 2186-2494
Titre abrégé: J Neuroendovasc Ther
Pays: Japan
ID NLM: 101488164
Informations de publication
Date de publication:
2021
2021
Historique:
received:
22
07
2020
accepted:
23
08
2020
medline:
1
1
2021
pubmed:
1
1
2021
entrez:
28
7
2023
Statut:
ppublish
Résumé
Intracranial vertebral artery dissection (VAD) is the most common arterial dissection in intracranial arteries. Some types of VAD can heal spontaneously after reconstitution of the vessel lumen with excellent prognosis, whereas others can progress to stroke that needs treatment. Recently, endovascular treatment (EVT) has emerged and is suggested as a treatment option for VADs due to perceived low rates of procedure-related morbidity with good efficacy. In the last decade, we have accumulated our strategies to treat those VADs. Here, we try to share our experiences about VADs, including indications and methods of treatment of VADs using EVT. We perform EVT for ruptured VADs presenting with SAH and some of unruptured VADs such as VAD with recurrent or progressive ischemia, dissecting aneurysm larger than 7 mm or with mass effect, early ugly change of VADs in shape and size during follow-up period, involving the basilar artery (BA) and bilateral VADs. We present how we have done in our real practice for the last decade for treating VADs by EVT rather than reviewing and organizing so-far-published literature. We tended to occlude the rupture point by vertebral artery (VA) occlusion in non-dominant VA or stent-assisted coiling in dominant VA for ruptured VADs. We tended to reconstruct original hemodynamics using various stents for unruptured VADs. To decide what to treat and how to treat are very complicated for VADs. However, we believe that EVT is the current mainstay for treating VADs. Each technique of EVT should be determined on a case-by-case basis at the discretion of endovascular neurosurgeons and/or interventional neuroradiologists according to presenting symptoms, hemodynamic status, including sufficiency of the collateral supply and anatomic features of the vertebrobasilar artery as well as the posterior inferior cerebellar artery, anterior spinal artery, and medullary perforators.
Identifiants
pubmed: 37501904
doi: 10.5797/jnet.ra.2020-0150
pii: jnet.ra.2020-0150
pmc: PMC10370974
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
265-280Informations de copyright
©2021 The Japanese Society for Neuroendovascular Therapy.
Déclaration de conflit d'intérêts
The authors declare that they have no conflicts of interest.
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