2014 Volume 26 Issue 2 Pages 27-31
Objective: Ruptured vertebral artery dissection (VAD) should be treated promptly because of the high risk of rebleeding. Endovascular treatment (EVT) for the ruptured VAD is thought to be a reliable technique to prevent rebleeding. Therefore, we retrospectively studied the efficacy and outcome of EVT for ruptured VAD.Methods: Twenty patients were diagnosed to have a ruptured VAD in the acute stage at our institute. Fifteen patients received EVT in the acute stage. Of those, twelve were treated by internal trapping of the dissected segment. Stent-assisted coiling was performed for a patient with contralateral hypoplastic VA, and for 2 cases with bilateral VADs. The clinical outcome at discharge from our hospital was analyzed using the Glasgow Outcome Scale (GOS).Results: In the EVT group, 6 patients had good recovery, 3 patients had moderate disability, and 6 patients had severe disability. There was no rebleeding and no procedure-related complication. However, six patients who received EVT developed ischemic complications due to procedure, which were associated with a poor outcome (P<0.05).Conclusion: EVT for ruptured VAD in the acute stage appears to be safe and effective, but care should be paid to post-treatment ischemic complications.
