Abstract
We report a patient with a right vertebral artery (VA) dissecting aneurysm who was treated by placing an Enterprise stent (Cordis Neurovascular, Miami Lakes, FL) from the proximal VA to the posterior inferior cerebellar artery (PICA) in order to save the patency of the PICA. A 47-year-old man was admitted with a ruptured right VA dissecting aneurysm that involved the origin of the PICA. A 4.5 × 37-mm Enterprise stent was then placed through the proximal VA to the PICA. The dissected segment of the VA was completely occluded by coil embolization. The 1-year follow-up angiography showed that the dissected segment was completely occluded and the diameter of the PICA was slightly increased, and the PICA’s patency was good.
References
Aoki N, Sakai T (1990) Rebleeding from intracranial dissecting aneurysm in the vertebral artery. Stroke 21:1628–1631
Hara M, Yamamoto I (2000) Introduction to symposium: intracranial dissecting aneurysms. Neuropathology 20:83–84
Iihara K, Sakai N, Murao K, Sakai H, Higashi T, Kogure S, Takahashi JC, Nagata I (2002) Dissecting aneurysms of the vertebral artery: a management strategy. J Neurosurg 97:259–267
Mercier PH, Brassier G, Fournier H-D, Picquet J, Papon X, Lasjaunias P (2008) Vascular microanatomy of the pontomedullary junction, posterior inferior cerebellar arteries, and the lateral spinal arteries. Interv Neuroradiol 14:49–58
Mizutani T, Aruga T, Kirino T, Miki Y, Saito I, Tsuchida T (1995) Recurrent subarachnoid hemorrhage from untreated ruptured vertebrobasilar dissecting aneurysms. Neurosurgery 36:905–913
Naito I, Iwai T, Sasaki T (2002) Management of intracranial cerebral artery dissection initially presenting without subarachnoid hemorrhage. Neurosurgery 51:930–938
Ogasawara K, Kubo Y, Tomitsuka N, Sasoh M, Otawara Y, Arai H, Ogawa A (2006) Treatment of vertebral artery aneurysms with transposition of the posterior inferior cerebellar artery to the vertebral artery combined with parent artery occlusion: Technical note. J Neurosurg 105:781–784
Rabinov JD, Hellinger FR, Morris PP, Ogilvy CS, Putman CM (2003) Endovascular management of vertebrobasilar dissecting aneurysms. AJNR Am J Neuroradiol 24:1421–1428
Sakata N, Takebayashi S, Kojima M, Masawa N, Suzuki K, Takatama M (2000) Pathology of a dissecting intracranial aneurysm. Neuropathology 20:104–108
Shin YS, Kim HS, Kim SY (2007) Stenting for vertebrobasilar dissection: a possible treatment option for nonhemorrhagic vertebrobasilar dissection. Neuroradiology 49:149–156
Siddiqui MA, Bhattacharya JJ, Lindsay KW, Jenkins S (2009) Horizontal stent-assisted coil embolization of wide-necked intracranial aneurysms with the Enterprise stent – a case series with early angiographic follow-up. Neuroradiology 51:411–418
Takikawa S, Kamiyama H, Nomura M, Abe H, Saitoh H (1991) Vertebral dissecting aneurysm treated with trapping and bilateral PICA side-to-side anastomosis: a case report. No Shinkei Geka 19:571–576
Turk AS, Niemann DB, Ahmed A, Aagaard-Kienitz B (2007) Use of self-expanding stents in distal small cerebral vessels. AJNR Am J Neuroradiol 28:533–536
Acknowledgements
We declare that we have no conflict of interest in relation to this article.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Chung, J., Kim, Bs., Lee, D. et al. 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 152, 1489–1492 (2010). https://doi.org/10.1007/s00701-010-0725-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00701-010-0725-3