Reconstructive endovascular treatment of the V4 segment of a vertebral artery dissecting aneurysm with the Willis covered stent: A retrospective study

• Published in: Interventional neuroradiology Vol. 25; no. 5; pp. 548 - 555
• Main Authors: Xiang, Sishi, Li, Guilin, He, Chuan, Ren, Jian, Zhang, Hongqi
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.10.2019
• Subjects: Adult; Aged; Cerebral Aneurysm; Cerebral Angiography; Endovascular Procedures - methods; Female; Follow-Up Studies; Humans; Intracranial Aneurysm - surgery; Magnetic Resonance Imaging; Male; Middle Aged; Postoperative Complications - epidemiology; Reconstructive Surgical Procedures - methods; Retrospective Studies; Stents; Treatment Outcome; Vertebral Artery Dissection - diagnostic imaging; Vertebral Artery Dissection - surgery; Endovascular procedure; intracranial dissecting aneurysm; vertebral artery; Willis covered stent
• ISSN: 1591-0199; 2385-2011
• DOI: 10.1177/1591019918824413

Objective Preliminary studies suggest that Willis covered stents may be suitable for the treatment of aneurysms of the internal carotid artery (ICA), but their efficacy and safety in vertebral artery (VA) dissecting aneurysms need further investigation. Methods Consecutive patients who underwent placement of a Willis covered stent for treatment of an aneurysm of the V4 segment of the VA between September 2015 and December 2017 at our institution were retrospectively reviewed. The efficacy, complications, angiographic and clinical follow-up results were collected and analyzed. Results Sixteen covered stents were successfully implanted into the VA in 12 patients with 12 dissecting aneurysms. The technical success rate of stenting placement was 100%. Complete occlusion was achieved in 11 patients immediately after stent placement, with transient endoleak in one aneurysm. Angiographic follow-up (9.9 ± 4.0 months, mean±SD) was performed in nine patients and demonstrated complete stabilization of the obliterated aneurysm. Clinical follow-up (20.1 ± 9.6 months, mean±SD) demonstrated full recovery in 11 patients, and one patient suffered from acute myocardial infarction. Conclusion Reconstruction using a Willis covered stent is an efficient, safe and attractive alternative for the definitive treatment of intracranial VA dissecting aneurysms; longer follow-up and expanded clinical trials are needed for further validation of this technique.