Outcomes of reconstructive endovascular treatment of vertebrobasilar dissecting aneurysms with intramural hematoma
BackgroundVertebrobasilar dissecting aneurysms (VBDAs) with an intramural hematoma (IMH) usually cause symptoms because of mass effect and grow in size over time. Clinical outcomes are generally poor.ObjectiveThis study aimed to examine outcomes of reconstructive endovascular treatment (EVT) in pati...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-08-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2022.914878/full |
| _version_ | 1818484803394076672 |
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| author | Yisen Zhang Qichen Peng Yangyang Zhou Chao Wang Longhui Zhang Xinjian Yang Shiqing Mu |
| author_facet | Yisen Zhang Qichen Peng Yangyang Zhou Chao Wang Longhui Zhang Xinjian Yang Shiqing Mu |
| author_sort | Yisen Zhang |
| collection | DOAJ |
| description | BackgroundVertebrobasilar dissecting aneurysms (VBDAs) with an intramural hematoma (IMH) usually cause symptoms because of mass effect and grow in size over time. Clinical outcomes are generally poor.ObjectiveThis study aimed to examine outcomes of reconstructive endovascular treatment (EVT) in patients with VBDAs with IMH. Safety and effectiveness were compared between flow diverters (FDs) and conventional stents.MethodsWe retrospectively analyzed the clinical and radiological data of 36 VBDAs with IMH in 36 patients who underwent EVT with either FDs or conventional stents from January 2012 to December 2020 at our institution.ResultsAmong the 36 study patients, 20 were treated with FDs and 16 with conventional stents. Incidence of procedure-related complications did not significantly differ between the two stents. IMH growth occurred after EVT in a significantly higher proportion of conventional stent group aneurysms (zero vs. 31.3% [5/16]; p = 0.012). Among the five aneurysms with IMHs that grew, all recurred. Change in IMH size after EVT was significantly lower in the FD group (−2.7 vs. +8.1%, p = 0.036). However, after the recurrent aneurysms were removed from the conventional stent group, change in IMH size did not significantly differ between the two groups (−2.7 vs. +1.0%, p = 0.332). The proportion of patients who experienced an improvement in mRS score after EVT was significantly higher in the FD group (60 vs. 25%, p = 0.036).ConclusionIMHs in VBDAs stop growing after successful reconstructive EVT. Although both FD and conventional stent treatment are effective, FD treatment may be superior based on clinical outcomes and effect on IMH size. |
| first_indexed | 2024-12-10T15:59:40Z |
| format | Article |
| id | doaj.art-1198fb31ddc447e49940eb62179495cb |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-10T15:59:40Z |
| publishDate | 2022-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-1198fb31ddc447e49940eb62179495cb2022-12-22T01:42:28ZengFrontiers Media S.A.Frontiers in Neurology1664-22952022-08-011310.3389/fneur.2022.914878914878Outcomes of reconstructive endovascular treatment of vertebrobasilar dissecting aneurysms with intramural hematomaYisen ZhangQichen PengYangyang ZhouChao WangLonghui ZhangXinjian YangShiqing MuBackgroundVertebrobasilar dissecting aneurysms (VBDAs) with an intramural hematoma (IMH) usually cause symptoms because of mass effect and grow in size over time. Clinical outcomes are generally poor.ObjectiveThis study aimed to examine outcomes of reconstructive endovascular treatment (EVT) in patients with VBDAs with IMH. Safety and effectiveness were compared between flow diverters (FDs) and conventional stents.MethodsWe retrospectively analyzed the clinical and radiological data of 36 VBDAs with IMH in 36 patients who underwent EVT with either FDs or conventional stents from January 2012 to December 2020 at our institution.ResultsAmong the 36 study patients, 20 were treated with FDs and 16 with conventional stents. Incidence of procedure-related complications did not significantly differ between the two stents. IMH growth occurred after EVT in a significantly higher proportion of conventional stent group aneurysms (zero vs. 31.3% [5/16]; p = 0.012). Among the five aneurysms with IMHs that grew, all recurred. Change in IMH size after EVT was significantly lower in the FD group (−2.7 vs. +8.1%, p = 0.036). However, after the recurrent aneurysms were removed from the conventional stent group, change in IMH size did not significantly differ between the two groups (−2.7 vs. +1.0%, p = 0.332). The proportion of patients who experienced an improvement in mRS score after EVT was significantly higher in the FD group (60 vs. 25%, p = 0.036).ConclusionIMHs in VBDAs stop growing after successful reconstructive EVT. Although both FD and conventional stent treatment are effective, FD treatment may be superior based on clinical outcomes and effect on IMH size.https://www.frontiersin.org/articles/10.3389/fneur.2022.914878/fullintracranial aneurysmdissectionintramural hematomavertebrobasilar arteryendovascular treatment |
| spellingShingle | Yisen Zhang Qichen Peng Yangyang Zhou Chao Wang Longhui Zhang Xinjian Yang Shiqing Mu Outcomes of reconstructive endovascular treatment of vertebrobasilar dissecting aneurysms with intramural hematoma Frontiers in Neurology intracranial aneurysm dissection intramural hematoma vertebrobasilar artery endovascular treatment |
| title | Outcomes of reconstructive endovascular treatment of vertebrobasilar dissecting aneurysms with intramural hematoma |
| title_full | Outcomes of reconstructive endovascular treatment of vertebrobasilar dissecting aneurysms with intramural hematoma |
| title_fullStr | Outcomes of reconstructive endovascular treatment of vertebrobasilar dissecting aneurysms with intramural hematoma |
| title_full_unstemmed | Outcomes of reconstructive endovascular treatment of vertebrobasilar dissecting aneurysms with intramural hematoma |
| title_short | Outcomes of reconstructive endovascular treatment of vertebrobasilar dissecting aneurysms with intramural hematoma |
| title_sort | outcomes of reconstructive endovascular treatment of vertebrobasilar dissecting aneurysms with intramural hematoma |
| topic | intracranial aneurysm dissection intramural hematoma vertebrobasilar artery endovascular treatment |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2022.914878/full |
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