Abstract
Occlusion of the parent artery for a vertebral artery dissecting aneurysm (VADA) with the posterior inferior cerebellar artery (PICA)‒end on the contralateral side causes a cerebral infarction (CI). We present the case details of two patients treated with stent‒assisted coiling (SAC) of a VADA with the PICA‒end on the contralateral side. Case 1: A 57‒year‒old man presented with dizziness. MRI showed a lateral medullary infarction, and digital subtraction angiography (DSA) demonstrated a VADA with the PICA‒end on the contralateral side. Because the VADA was growing, SAC of the VADA with the PICA‒end on the contralateral side was performed. No CI or subarachnoid hemorrhage (SAH) occurred. Case 2: A 41‒year‒old man presented with left occipital pain and decreased consciousness. CT showed SAH, and DSA demonstrated a ruptured VADA. SAC of the VADA with the PICA‒end on the contralateral side was performed. No CI or SAH occurred. SAC of a VADA with the PICA‒end on the contralateral side is useful because it preserves the parent artery and prevents VADA rupture.
