Korean J Cerebrovasc Surg.  2011 Mar;13(1):19-23.

Internal Trapping Using Detachable Coils for Ruptured Vertebral Artery-dissecting Aneurysms: Case Report

• Lee SH
• Lim DJ
• Ha SK
• Kim SD
• Kim SH
• Park JY

Abstract

Ruptured vertebral artery- dissecting aneurysms (VADAs) must be treated as early as possible due to frequent rebleeding in the early stage. We have reported herein two patients with VADAs who were treated using internal trapping using detachable coils. Both patients were young females in their 40's. They had been admitted to the emergency clinic due to severe headaches and mental deterioration. Brain computed tomography (CT) scans revealed a subarachnoid hemorrhages in the posterior fossa, and transfemoral catheter cerebral angiography revealed dissecting aneurysms at the dominant vertebral arteries. Under general anesthesia, embolization of the parent artery, including the aneurysmal portion, using Guglielmi detachable coils was performed without any procedural complications. Before the induction of general anesthesia, a balloon test occlusion was done on both patients. Both patients improved well after surgery. One patient underwent cerebral angiography at six months after surgery and showed no recurrence of the aneurysm or recanalization of the parent artery. Both patients were free of neurologic findings on follow-up at the 6- and 12- month. Based on these results, patients with ruptured VADAs, located in the dominant vertebral arteries, may be successfully treated with urgent internal trapping using an endovascular technique in selected cases.

Keyword

Subarachnoid hemorrhage; Dissecting aneurysm; Vertebral artery; Balloon occlusion; Therapeutic embolization

MeSH Terms

Anesthesia, General
Aneurysm
Aneurysm, Dissecting
Arteries
Balloon Occlusion
Brain
Catheters
Cerebral Angiography
Embolization, Therapeutic
Emergencies
Endovascular Procedures
Female
Follow-Up Studies
Headache
Humans
Neurologic Manifestations
Parents
Recurrence
Subarachnoid Hemorrhage
Vertebral Artery