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논문 기본 정보

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학술저널
저자정보
Lim, Seung Hoon (Department of Neurosurgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine) Shin, Hee Sup (Department of Neurosurgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine) Lee, Seung Hwan (Department of Neurosurgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine) Koh, Jun Seok (Department of Neurosurgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine)
저널정보
대한신경외과학회 대한신경외과학회지 대한신경외과학회지 제58권 제3호
발행연도
2015.1
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175 - 183 (9page)

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Objective : Intracranial ruptured vertebral artery dissecting aneurysms (VADAns) are associated with high morbidity and mortality when left untreated due to the high likelihood of rebleeding. The present study aimed to establish an endovascular therapeutic strategy that focuses specifically on the angioarchitecture of ruptured VADAns. Methods : Twenty-three patients with ruptured VADAn received endovascular treatment (EVT) over 7 years. The patient group included 14 women (60.9%) and 9 men (39.1%) between the ages of 39 and 72 years (mean age 54.2 years). Clinical data and radiologic findings were retrospectively analyzed. Results : Four patients had aneurysms on the dominant vertebral artery. Fourteen (61%) aneurysms were located distal to the posterior inferior cerebellar artery (PICA). Six (26%) patients had an extracranial origin of the PICA on the ruptured VA, and 2 patients (9%) had bilateral VADAns. Eighteen patients (78%) were treated with internal coil trapping. Two patients (9%) required an adjunctive bypass procedure. Seven patients (30%) required stent-supported endovascular procedures. Two patients experienced intra-procedural rupture during EVT, one of which was associated with a focal medullary infarction. Two patients (9%) exhibited recanalization of the VADAn during follow-up, which required additional coiling. No recurrent hemorrhage was observed during the follow-up period. Conclusion : EVT of ruptured VADAns based on angioarchitecture is a feasible and effective armamentarium to prevent fatal hemorrhage recurrence with an acceptable low risk of procedural complications. Clinical outcomes depend mainly on the pre-procedural clinical state of the patient. Radiologic follow-up is necessary to prevent hemorrhage recurrence after EVT.
#Vertebral artery dissecting aneurysm #Subarachnoid hemorrhage #Endovascular treatment

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참고문헌 (33)

참고문헌 신청
Aoki N. / 1990 / Rebleeding from intracranial dissecting aneurysm in the vertebral artery / Stroke 21:1628~1631 google schola Arnold M. / 2006 / Vertebral artery dissection : presenting findings and predictors of outcome / Stroke 37:2499~2503 google schola Chen YA. / 2013 / Stent placement to treat ruptured vertebral dissecting aneurysms / Interv Neuroradiol 19:479~482 google schola Chung J. / 2010 / Vertebral artery occlusion with vertebral artery-to-posterior inferior cerebellar artery stenting for preservation of the PICA in treating ruptured vertebral artery dissection / Acta Neurochir(Wien) 152:1489~1492 google schola Seung Young Chung / 2014 / A Case of Endovascular Treatment for Followed by Side to Side Bypass for Vertebral Artery Dissecting Aneurysms Involved Posterior Inferior Cerebellar Artery / 대한신경외과학회지 55(1):36~39 google schola

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