Document Detail

Treatment of a vertebral dissecting aneurysm with stents and coils: technical case report.
MedLine Citation:
PMID:  9696097     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE AND IMPORTANCE: A clinical case of a dissecting aneurysm of the intracranial vertebral artery successfully treated with a combination of stents and coils is presented. The importance of long-term follow-up and the development of suitable materials and devices are emphasized. CLINICAL PRESENTATION: This 48-year-old man with a history of progressive bilateral loss of vision caused by glaucoma developed sudden headache, nausea, and vomiting. At admission, he presented with psychomotor agitation and neck pain. A neurological examination showed bilateral IInd and VIth cranial nerve palsy and neck stiffness. Computed tomography demonstrated a diffuse subarachnoid hemorrhage. Digital subtraction angiography showed a fusiform dilation of Segment IV of the left vertebral artery, with a double lumen sign. TECHNIQUE: A bifemoral intra-arterial approach was used. A FasTracker 18 (Target Therapeutics, Fremont, CA) microcatheter was advanced through the true arterial lumen and was then replaced by a self-expandable metallic wall stent. Because of reduced radiopacity, a balloon-expandable metallic stent was then placed as well. Next, with a FasTracker 10 advanced through the stent mesh, the aneurysm was embolized using Guglielmi detachable coils. CONCLUSION: We applied a new technique to treat a dissecting aneurysm of the intracranial portion of the vertebral artery with a combination of stents and coils. Further work is required on the tracking, flexibility, and thrombogenic properties of diverse materials and devices. This evolving technology may play a role in the near future as the alternative of choice in some cases of aneurysm treatment via the endovascular route.
P Lylyk; R Ceratto; D Hurvitz; A Basso
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Neurosurgery     Volume:  43     ISSN:  0148-396X     ISO Abbreviation:  Neurosurgery     Publication Date:  1998 Aug 
Date Detail:
Created Date:  1998-11-24     Completed Date:  1998-11-24     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  385-8     Citation Subset:  IM    
Endovascular Neurosurgery Department, Belgrano Adventist Clinic, Buenos Aires, Argentina.
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MeSH Terms
Aneurysm, Dissecting / radiography,  therapy*
Angiography, Digital Subtraction
Cerebral Angiography
Combined Modality Therapy
Embolization, Therapeutic / instrumentation*
Follow-Up Studies
Intracranial Aneurysm / radiography,  therapy*
Middle Aged
Neurologic Examination
Tomography, X-Ray Computed
Vertebral Artery* / radiography
Comment In:
Neurosurgery. 1998 Aug;43(2):377-9   [PMID:  9696095 ]

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