OBJECTIVE: Ruptured vertebral artery dissecting aneurysms (VADA) must be secured quickly to prevent re-hemorrhage. Endovascular coil embolization (ECM) of the dissecting segment is a well-established treatment method, however postoperative recanalization rates are not well presented. This study investigated the risk factors causing recanalization.

METHODS: Seventy-five patients who underwent ECM for VADA presented to our institution between 2000 and 2017. The medical records and image data of each patient were reviewed. The occurrence of recanalization was examined using digital subtraction angiography (DSA) seven days after treatment. Various measurements were performed on DSA, and the risk factors for recanalization were analyzed. 

RESULTS: During the study period, five patients (6.7%) with ECM for VADA presented with postoperative recanalization in DSA seven days after coil embolization. All five patients were not suffering from re-hemorrhage. The sites of dissecting aneurysm in these five cases were distal to origin of posterior inferior cerebellar artery (PICA). The length of coil embolization in recanalization patients was significantly shorter than that in non-recanalization patients. The number and type of coil were not significantly different in this study.

CONCLUSIONS: In the patients with the endovascular treatment for　VADA, we should pay attention to the site of dissecting region and the length of coil trapping for avoiding to overlook the recanalization.

RECANALIZATION AFTER THE ENDOVASCULAR TREATMENT FOR VERTEBRAL ARTERY DISSECTING ANEURYSM

RECANALIZATION AFTER THE ENDOVASCULAR TREATMENT FOR　VERTEBRAL ARTERY DISSECTING ANEURYSM