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CC BY-NC-ND 4.0 · Asian J Neurosurg 2019; 14(02): 561-564
DOI: 10.4103/ajns.AJNS_251_18
Case Report

Staged endovascular treatment of ruptured vertebral artery dissection involving the posterior inferior cerebellar artery

Yukihiro Yamao
1   Department of Neurosurgery, Koseikai Takeda Hospital
2   Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto
,
Eiji Ogino
1   Department of Neurosurgery, Koseikai Takeda Hospital
3   Department of Neurosurgery, Uji Tokushukai Medical Center, Kyoto
,
Sadaharu Torikoshi
1   Department of Neurosurgery, Koseikai Takeda Hospital
2   Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto
,
Waro Taki
1   Department of Neurosurgery, Koseikai Takeda Hospital
,
Masaki Nishimura
1   Department of Neurosurgery, Koseikai Takeda Hospital
4   Department of Neurosurgery, National Cerebral and Cardiovascular Center, Suita, Osaka
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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.

Key-words:

Antiplatelet therapy - endovascular treatment - stent-assisted coil embolization - vertebral artery dissection

Financial support and sponsorship

Nil.




Publication History

Article published online:
09 September 2022

© 2019. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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