Endovascular treatment of vertebrobasilar large dissecting aneurysms

Objectives To summarize the clinical outcomes of endovascular treatment of vertebrobasilar large dissecting aneurysms (VBLDAs) and to evaluate the effectiveness of endovascular treatment for VBLDAs. Methods The clinical data, therapeutic effects and follow-up results of 44 VBLDAs in 41 patients admitted to Department of Neurological Intervention, Beijing Tiantan Hospital, Capital Medical University from January 2010 to May 2016 were analyzed retrospectively to investigate the efficacy of endovascular treatment for VBLDAs.Among 41 VBLDAs patients undergoing endovascular treatment, 18 (43.9%) were treated with stent alone, 18 (43.9%) with stent-assisted coil embolization and 5 (12.2%) with parent artery occlusion.Patients outcome was evaluated by modified Rank Scale (mRS). Results Immediate post-operative angiography showed complete occlusion in 9 (22.0%) cases, nearly complete occlusion in 24 (58.5%) and partial occlusion in 8 (19.5%) cases. None of the 41 patients had any complications during the procedures. Four patients had complications post surgery.The follow-up period is 3-60 months(mean: 12.4±11.3 months). The mRS was 0-1 in 30 case, 2-4 in 6 cases, 5-6 in 5 cases.Postoperative follow-up revealed deaths in 5 (12.2% ) patients, recurrence in 4 (9.8%) and no recurrence in 32 (78.0%). Conclusion The therapeutic effect of endovascular treatment of VBLDAs does not seem to be satisfactory and the recurrence and mortality rates of VBLDAs patients are relatively high. Key words: Intracranial aneurysm; Aneurysm, dissecting; Vertebrobasilar artery; Endovascular treatment; Treatment outcome