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Treatment of Ruptured Vertebral Artery Dissecting Aneurysms Distal to the Posterior Inferior Cerebellar Artery: Stenting or Trapping?

Fang, Yi-Bin ; Zhao, Kai-Jun ; Wu, Yi-Na ; Zhou, Yu ; Li, Qiang ; Yang, Peng-Fei ; Huang, Qing-Hai ; Zhao, Wen-Yuan ; Xu, Yi ; Liu, Jian-Min

Cardiovascular and interventional radiology, 2015-06, Vol.38 (3), p.592-599 [Periódico revisado por pares]

New York: Springer US

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Título:
Treatment of Ruptured Vertebral Artery Dissecting Aneurysms Distal to the Posterior Inferior Cerebellar Artery: Stenting or Trapping?
Autor: Fang, Yi-Bin ; Zhao, Kai-Jun ; Wu, Yi-Na ; Zhou, Yu ; Li, Qiang ; Yang, Peng-Fei ; Huang, Qing-Hai ; Zhao, Wen-Yuan ; Xu, Yi ; Liu, Jian-Min
Assuntos: Adult ; Aneurysm, Ruptured - diagnostic imaging ; Aneurysm, Ruptured - therapy ; ARTERIES ; BIOMEDICAL RADIOGRAPHY ; Cardiology ; Cerebral Angiography ; Cerebral Arteries - diagnostic imaging ; Clinical Investigation ; COMPARATIVE EVALUATIONS ; Embolization, Therapeutic ; Female ; Follow-Up Studies ; Humans ; Imaging ; Intracranial Aneurysm - diagnostic imaging ; Intracranial Aneurysm - therapy ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Nuclear Medicine ; Radiology ; RADIOLOGY AND NUCLEAR MEDICINE ; Retrospective Studies ; REVIEWS ; Rupture, Spontaneous ; RUPTURES ; SAFETY ; Stents ; TRAPPING ; Treatment Outcome ; Ultrasound ; Vertebral Artery - diagnostic imaging ; Vertebral Artery Dissection - diagnostic imaging ; Vertebral Artery Dissection - therapy
É parte de: Cardiovascular and interventional radiology, 2015-06, Vol.38 (3), p.592-599
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
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Descrição: Purpose The treatment of ruptured vertebral artery dissecting aneurysms (VADAs) continues to be controversial. Our goal was to evaluate the safety, efficacy, and long-term outcomes of internal trapping and stent-assisted coiling (SAC) for ruptured VADAs distal to the posterior inferior cerebellar artery (supra-PICA VADAs), which is the most common subset. Methods A retrospective review was conducted of 39 consecutive ruptured supra-PICA VADAs treated with internal trapping ( n = 20) or with SAC ( n = 19) at our institution. The clinical and angiographic data were retrospectively compared. Results The immediate total occlusion rate of the VADAs was 80 % in the trapping group, which improved to 88.9 % at the follow-ups (45 months on average). Unwanted occlusions of the posterior inferior cerebellar artery (PICA) were detected in three trapped cases. Incomplete obliteration of the VADA or unwanted occlusions of the PICA were detected primarily in the VADAs closest to the PICA. In the stenting group, the immediate total occlusion rate was 47.4 %, which improved to 100 % at the follow-ups (39 months on average). The immediate total occlusion rate of the VADAs was higher in the trapping group ( p < 0.05), but the later total occlusion was slightly higher in the stenting group ( p > 0.05). Conclusions Our preliminary results showed that internal trapping and stent-assisted coiling are both technically feasible for treating ruptured supra-PICA VADAs. Although not statistically significant, procedural related complications occurred more frequently in the trapping group. When the VADAs are close to the PICA, we suggest that the lesions should be treated using SAC.
Editor: New York: Springer US
Idioma: Inglês

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Treatment of Ruptured Vertebral Artery Dissecting Aneurysms Distal to the Posterior Inferior Cerebellar Artery: Stenting or Trapping?

Fang, Yi-Bin ; Zhao, Kai-Jun ; Wu, Yi-Na ; Zhou, Yu ; Li, Qiang ; Yang, Peng-Fei ; Huang, Qing-Hai ; Zhao, Wen-Yuan ; Xu, Yi ; Liu, Jian-Min

New York: Springer US

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