Open AccessStaged endovascular treatment of ruptured vertebral artery dissection involving the posterior inferior cerebellar artery
Author(s) -
Yukihiro Yamao,
Eiji Ogino,
Sadaharu Torikoshi,
Waro Taki,
Masaki Nakagawa
Publication year - 2019
Publication title -
asian journal of neurosurgery
Language(s) - English
Resource type - Journals
ISSN - 1793-5482
DOI - 10.4103/ajns.ajns_251_18
Subject(s) - medicine , posterior inferior cerebellar artery , pica (typography) , vertebral artery , vertebral artery dissection , dissection (medical) , surgery , stent , endovascular treatment , radiology , embolization , aneurysm , world wide web , computer science
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.