Incidence and risk factors of recurrence after endovascular treatment of intracranial vertebrobasilar dissecting aneurysms

Byungmoon Kim, Yong Sam Shin, Se Hyuk Kim, Sang Hyun Suh, Yon Kwon Ihn, Dong Ik Kim, Dong Joon Kim, Sung Il Park

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Abstract

Background and Purpose-The incidence and risk factors for recurrence after endovascular treatment of intracranial vertebrobasilar dissecting aneurysms (VBDAs) have not been studied. We aimed to evaluate the incidence and risk factors for recurrence after endovascular treatment of VBDAs. Methods-A total of 111 patients (mean age, 45±10 years) underwent endovascular treatment for 119 VBDAs (ruptured/unruptured=73:46). Incidence and risk factors for recurrence were retrospectively evaluated. Results-Sixty-two VBDAs were treated by a reconstructive technique by using 1 to 3 overlapping stents with or without coiling, and 57 VBDAs were treated by a deconstructive technique by using proximal occlusion or internal trapping at the dissected segment of the parent artery. Follow-up angiography was available for 97 VBDAs (81.5%) in 89 patients at 3 days to 48 months (median, 13 months) after treatment. There were 13 recurrences: 6 had rebleeding but 7 had no rebleeding. All 6 hemorrhagic recurrences had initially presented with a ruptured form. Ten recurrences were confirmed by angiography, but 3 recurrences with rebleeding did not receive follow-up angiography. The rate of post-treatment recurrence did not differ between reconstructive and deconstructive treatments. Involvement of the posterior inferior cerebellar artery origin (odds ratio=8.026; 95% confidence interval, 1.561 to 41.259; P=0.013) was the only independent risk factor for recurrence. Conclusions-There was a 13% recurrence after endovascular treatment of VBDAs. Posterior inferior cerebellar artery origin involvement was the only independent risk factor for recurrence after endovascular treatment of VBDAs.

Original languageEnglish
Pages (from-to)2425-2430
Number of pages6
JournalStroke
Volume42
Issue number9
DOIs
Publication statusPublished - 2011 Sep 1

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Dissecting Aneurysm
Recurrence
Incidence
Therapeutics
Angiography
Arteries
Stents
Odds Ratio

All Science Journal Classification (ASJC) codes

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialised Nursing

Cite this

Kim, Byungmoon ; Shin, Yong Sam ; Kim, Se Hyuk ; Suh, Sang Hyun ; Ihn, Yon Kwon ; Kim, Dong Ik ; Kim, Dong Joon ; Park, Sung Il. / Incidence and risk factors of recurrence after endovascular treatment of intracranial vertebrobasilar dissecting aneurysms. In: Stroke. 2011 ; Vol. 42, No. 9. pp. 2425-2430.
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abstract = "Background and Purpose-The incidence and risk factors for recurrence after endovascular treatment of intracranial vertebrobasilar dissecting aneurysms (VBDAs) have not been studied. We aimed to evaluate the incidence and risk factors for recurrence after endovascular treatment of VBDAs. Methods-A total of 111 patients (mean age, 45±10 years) underwent endovascular treatment for 119 VBDAs (ruptured/unruptured=73:46). Incidence and risk factors for recurrence were retrospectively evaluated. Results-Sixty-two VBDAs were treated by a reconstructive technique by using 1 to 3 overlapping stents with or without coiling, and 57 VBDAs were treated by a deconstructive technique by using proximal occlusion or internal trapping at the dissected segment of the parent artery. Follow-up angiography was available for 97 VBDAs (81.5{\%}) in 89 patients at 3 days to 48 months (median, 13 months) after treatment. There were 13 recurrences: 6 had rebleeding but 7 had no rebleeding. All 6 hemorrhagic recurrences had initially presented with a ruptured form. Ten recurrences were confirmed by angiography, but 3 recurrences with rebleeding did not receive follow-up angiography. The rate of post-treatment recurrence did not differ between reconstructive and deconstructive treatments. Involvement of the posterior inferior cerebellar artery origin (odds ratio=8.026; 95{\%} confidence interval, 1.561 to 41.259; P=0.013) was the only independent risk factor for recurrence. Conclusions-There was a 13{\%} recurrence after endovascular treatment of VBDAs. Posterior inferior cerebellar artery origin involvement was the only independent risk factor for recurrence after endovascular treatment of VBDAs.",
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Incidence and risk factors of recurrence after endovascular treatment of intracranial vertebrobasilar dissecting aneurysms. / Kim, Byungmoon; Shin, Yong Sam; Kim, Se Hyuk; Suh, Sang Hyun; Ihn, Yon Kwon; Kim, Dong Ik; Kim, Dong Joon; Park, Sung Il.

In: Stroke, Vol. 42, No. 9, 01.09.2011, p. 2425-2430.

Research output: Contribution to journalArticle

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T1 - Incidence and risk factors of recurrence after endovascular treatment of intracranial vertebrobasilar dissecting aneurysms

AU - Kim, Byungmoon

AU - Shin, Yong Sam

AU - Kim, Se Hyuk

AU - Suh, Sang Hyun

AU - Ihn, Yon Kwon

AU - Kim, Dong Ik

AU - Kim, Dong Joon

AU - Park, Sung Il

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N2 - Background and Purpose-The incidence and risk factors for recurrence after endovascular treatment of intracranial vertebrobasilar dissecting aneurysms (VBDAs) have not been studied. We aimed to evaluate the incidence and risk factors for recurrence after endovascular treatment of VBDAs. Methods-A total of 111 patients (mean age, 45±10 years) underwent endovascular treatment for 119 VBDAs (ruptured/unruptured=73:46). Incidence and risk factors for recurrence were retrospectively evaluated. Results-Sixty-two VBDAs were treated by a reconstructive technique by using 1 to 3 overlapping stents with or without coiling, and 57 VBDAs were treated by a deconstructive technique by using proximal occlusion or internal trapping at the dissected segment of the parent artery. Follow-up angiography was available for 97 VBDAs (81.5%) in 89 patients at 3 days to 48 months (median, 13 months) after treatment. There were 13 recurrences: 6 had rebleeding but 7 had no rebleeding. All 6 hemorrhagic recurrences had initially presented with a ruptured form. Ten recurrences were confirmed by angiography, but 3 recurrences with rebleeding did not receive follow-up angiography. The rate of post-treatment recurrence did not differ between reconstructive and deconstructive treatments. Involvement of the posterior inferior cerebellar artery origin (odds ratio=8.026; 95% confidence interval, 1.561 to 41.259; P=0.013) was the only independent risk factor for recurrence. Conclusions-There was a 13% recurrence after endovascular treatment of VBDAs. Posterior inferior cerebellar artery origin involvement was the only independent risk factor for recurrence after endovascular treatment of VBDAs.

AB - Background and Purpose-The incidence and risk factors for recurrence after endovascular treatment of intracranial vertebrobasilar dissecting aneurysms (VBDAs) have not been studied. We aimed to evaluate the incidence and risk factors for recurrence after endovascular treatment of VBDAs. Methods-A total of 111 patients (mean age, 45±10 years) underwent endovascular treatment for 119 VBDAs (ruptured/unruptured=73:46). Incidence and risk factors for recurrence were retrospectively evaluated. Results-Sixty-two VBDAs were treated by a reconstructive technique by using 1 to 3 overlapping stents with or without coiling, and 57 VBDAs were treated by a deconstructive technique by using proximal occlusion or internal trapping at the dissected segment of the parent artery. Follow-up angiography was available for 97 VBDAs (81.5%) in 89 patients at 3 days to 48 months (median, 13 months) after treatment. There were 13 recurrences: 6 had rebleeding but 7 had no rebleeding. All 6 hemorrhagic recurrences had initially presented with a ruptured form. Ten recurrences were confirmed by angiography, but 3 recurrences with rebleeding did not receive follow-up angiography. The rate of post-treatment recurrence did not differ between reconstructive and deconstructive treatments. Involvement of the posterior inferior cerebellar artery origin (odds ratio=8.026; 95% confidence interval, 1.561 to 41.259; P=0.013) was the only independent risk factor for recurrence. Conclusions-There was a 13% recurrence after endovascular treatment of VBDAs. Posterior inferior cerebellar artery origin involvement was the only independent risk factor for recurrence after endovascular treatment of VBDAs.

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