Rapidly Growing Vertebral Artery Dissecting Aneurysm treated by Flow Diverter Placement

Abstract

  Although the natural course of an unruptured vertebral artery (VA) dissecting aneurysm is good, aneurysmal rupture during the follow-up period is experienced in some rare cases. In this report, we describe a case of an unruptured right VA dissecting aneurysm accompanied by a strong occipital headache. Enlargement and morphological changes in the aneurysm were observed within 12 days of admission. Because the perforator and anterior spinal artery branched out within and adjacent to the dissected portion, respectively, ischemic complications related to endovascular treatment are of great concern. The aneurysm was successfully treated with flow diverter (FD) placement in the parent artery, and a 3-month follow-up angiogram confirmed complete occlusion of the aneurysm and patency of the perforators. The FD is considered an effective treatment method for rapidly growing VA dissecting aneurysms, which makes it possible to prevent rupture and preserve branching perforators.