Staged endovascular treatment of ruptured vertebral artery dissection involving the posterior inferior cerebellar artery.

Yamao, Yukihiro; Ogino, Eiji; Torikoshi, Sadaharu; Taki, Waro; Nishimura, Masaki

In the treatment of vertebral artery (VA) dissection involving the origin of the posterior inferior cerebellar artery (PICA), the prevention of rebleeding and the preservation of VA and PICA patency are challenging. We report a case with ruptured VA dissection involving the origin of the PICA. In the acute stage, the fusiform dilatation of the dissection was first treated by means of stent-assisted coil embolization. Dual-antiplatelet therapy was administered just before stent placement. Seven days after the first treatment, two additional stents without coils were added. Rebleeding did not occur, and the lesion was thrombosed successfully 4 days after the second treatment, with the preservation of VA and PICA patency. This staged therapy appears to be beneficial in preventing rebleeding and in preserving VA and PICA patency.

VERTEBRAL artery dissections; VERTEBRAL artery; THERAPEUTICS; ARTERIES

Asian Journal of Neurosurgery, 2019, Vol 14, Issue 2, p561

1793-5482

Academic Journal

10.4103/ajns.AJNS_251_18