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Treatment of Dissecting Distal Vertebral Artery (V4) Aneurysms With Flow Diverters.

Publication ,  Journal Article
Corley, JA; Zomorodi, A; Gonzalez, LF
Published in: Oper Neurosurg (Hagerstown)
July 1, 2018

BACKGROUND: Dissecting aneurysms of the intracranial vertebral arteries are rare; however, treatment of these presents multiple challenges, including high risk of rebleeding, development of thromboembolic strokes, and progressive partial thrombosis. Flow diverters, such as Pipeline Endovascular Devices (PEDs; Covidien, Medtronic Inc, Dublin, Ireland), have emerged as a potential treatment option. OBJECTIVE: To present our experience with patients treated at our institution with PEDs for dissecting distal vertebral artery (V4 segment) aneurysms. METHODS: A retrospective search of our prospectively maintained database was performed between January 2014 and December 2016. We queried our database for all patients treated with PED for dissecting aneurysms of the V4 segment. Information was gathered including demographics, the location and morphology of the aneurysm, the clinical presentation, specific form of treatment, complications, antiplatelet medication regimen, and follow-up time. RESULTS: There were a total of 9 patients with dissecting V4 aneurysms treated with PED during the study period. All were treated initially with an average of 1.2 PEDs. All patients were followed with at least one repeat diagnostic angiogram and there was no residual aneurysm seen in 8 of 9 cases. In those that presented with neurological deficits, there was an average improvement in modified Rankin Scale of 2.85 points. CONCLUSION: PED is a safe and effective tool that can be used to treat ruptured dissecting aneurysms of this specific segment of the posterior circulation, but it does require close management of antiplatelet therapy in the setting of subarachnoid hemorrhage and close angiographic follow-up.

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Published In

Oper Neurosurg (Hagerstown)

DOI

EISSN

2332-4260

Publication Date

July 1, 2018

Volume

15

Issue

1

Start / End Page

1 / 9

Location

United States

Related Subject Headings

  • Vertebral Artery Dissection
  • Treatment Outcome
  • Retrospective Studies
  • Middle Aged
  • Male
  • Humans
  • Female
  • Endovascular Procedures
  • Embolization, Therapeutic
  • Databases, Factual
 

Citation

APA
Chicago
ICMJE
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Corley, J. A., Zomorodi, A., & Gonzalez, L. F. (2018). Treatment of Dissecting Distal Vertebral Artery (V4) Aneurysms With Flow Diverters. Oper Neurosurg (Hagerstown), 15(1), 1–9. https://doi.org/10.1093/ons/opx180
Corley, Jacquelyn A., Ali Zomorodi, and L Fernando Gonzalez. “Treatment of Dissecting Distal Vertebral Artery (V4) Aneurysms With Flow Diverters.Oper Neurosurg (Hagerstown) 15, no. 1 (July 1, 2018): 1–9. https://doi.org/10.1093/ons/opx180.
Corley JA, Zomorodi A, Gonzalez LF. Treatment of Dissecting Distal Vertebral Artery (V4) Aneurysms With Flow Diverters. Oper Neurosurg (Hagerstown). 2018 Jul 1;15(1):1–9.
Corley, Jacquelyn A., et al. “Treatment of Dissecting Distal Vertebral Artery (V4) Aneurysms With Flow Diverters.Oper Neurosurg (Hagerstown), vol. 15, no. 1, July 2018, pp. 1–9. Pubmed, doi:10.1093/ons/opx180.
Corley JA, Zomorodi A, Gonzalez LF. Treatment of Dissecting Distal Vertebral Artery (V4) Aneurysms With Flow Diverters. Oper Neurosurg (Hagerstown). 2018 Jul 1;15(1):1–9.
Journal cover image

Published In

Oper Neurosurg (Hagerstown)

DOI

EISSN

2332-4260

Publication Date

July 1, 2018

Volume

15

Issue

1

Start / End Page

1 / 9

Location

United States

Related Subject Headings

  • Vertebral Artery Dissection
  • Treatment Outcome
  • Retrospective Studies
  • Middle Aged
  • Male
  • Humans
  • Female
  • Endovascular Procedures
  • Embolization, Therapeutic
  • Databases, Factual