PMID- 27587971
OWN - NLM
STAT- MEDLINE
DCOM- 20170731
LR  - 20221207
IS  - 2005-8330 (Electronic)
IS  - 1229-6929 (Print)
IS  - 1229-6929 (Linking)
VI  - 17
IP  - 5
DP  - 2016 Sep-Oct
TI  - Stent-Assisted Coil Embolization of Vertebrobasilar Dissecting Aneurysms: 
      Procedural Outcomes and Factors for Recanalization.
PG  - 801-10
LID - 10.3348/kjr.2016.17.5.801 [doi]
AB  - OBJECTIVE: Outcomes of stent-assisted coil embolization (SACE) have not been well 
      established in the setting of vertebrobasilar dissecting aneurysms (VBDAs) due to 
      the low percentage of cases that need treatment and the array of available 
      therapeutic options. Herein, we presented clinical and radiographic results of 
      SACE in patients with VBDAs. MATERIALS AND METHODS: A total of 47 patients (M:F, 
      30:17; mean age +/- SD, 53.7 +/- 12.6 years), with a VBDA who underwent SACE between 
      2008 and 2014 at two institutions were evaluated retrospectively. Medical records 
      and radiologic data were analyzed to assess the outcome of SACE procedures. Cox 
      proportional hazards regression analysis was conducted to determine the factors 
      that were associated with aneurysmal recanalization after SACE. RESULTS: 
      Stent-assisted coil embolization technically succeeded in all patients. Three 
      cerebellar infarctions occurred on postembolization day 1, week 2, and month 2, 
      but no other procedure-related complications developed. Immediately following 
      SACE, 25 aneurysms (53.2%) showed no contrast filling into the aneurysmal sac. 
      During a mean follow-up of 20.2 months, 37 lesions (78.7%) appeared completely 
      occluded, whereas 10 lesions showed recanalization, 5 of which required 
      additional embolization. Overall recanalization rate was 12.64% per lesion-year, 
      and mean postoperative time to recanalization was 18 months (range, 3-36 months). 
      In multivariable analysis, major branch involvement (hazard ratio [HR]: 7.28; p = 
      0.013) and the presence of residual sac filling (HR: 8.49, p = 0.044) were 
      identified as statistically significant independent predictors of recanalization. 
      No bleeding was encountered in follow-up monitoring. CONCLUSION: Stent-assisted 
      coil embolization appears feasible and safe for treatment of VBDAs. Long-term 
      results were acceptable in a majority of patients studied, despite a relatively 
      high rate of incomplete occlusion immediately after SACE. Major branch 
      involvement and coiled aneurysms with residual sac filling may predispose to 
      recanalization.
FAU - Jeon, Jin Pyeong
AU  - Jeon JP
AD  - Department of Neurosurgery, Hallym University College of Medicine, Chuncheon 
      24253, Korea.
FAU - Cho, Young Dae
AU  - Cho YD
AD  - Department of Radiology, Seoul National University College of Medicine, Seoul 
      National University Hospital, Seoul 03080, Korea.
FAU - Rhim, Jong Kook
AU  - Rhim JK
AD  - Department of Neurosurgery, Jeju National University College of Medicine, Jeju 
      National University Hospital, Jeju 63241, Korea.
FAU - Park, Jeong Jin
AU  - Park JJ
AD  - Department of Neurology, Konkuk University Hospital, Konkuk University School of 
      Medicine, Seoul 05030, Korea.
FAU - Cho, Won-Sang
AU  - Cho WS
AD  - Department of Neurosurgery, Seoul National University College of Medicine, Seoul 
      National University Hospital, Seoul 03080, Korea.
FAU - Kang, Hyun-Seung
AU  - Kang HS
AD  - Department of Neurosurgery, Seoul National University College of Medicine, Seoul 
      National University Hospital, Seoul 03080, Korea.
FAU - Kim, Jeong Eun
AU  - Kim JE
AD  - Department of Neurosurgery, Seoul National University College of Medicine, Seoul 
      National University Hospital, Seoul 03080, Korea.
FAU - Hwang, Gyojun
AU  - Hwang G
AD  - Department of Neurosurgery, Seoul National University College of Medicine, Seoul 
      National University Bundang Hospital, Seongnam 13620, Korea.
FAU - Kwon, O-Ki
AU  - Kwon OK
AD  - Department of Neurosurgery, Seoul National University College of Medicine, Seoul 
      National University Bundang Hospital, Seongnam 13620, Korea.
FAU - Han, Moon Hee
AU  - Han MH
AD  - Department of Radiology, Seoul National University College of Medicine, Seoul 
      National University Hospital, Seoul 03080, Korea.; Department of Neurosurgery, 
      Seoul National University College of Medicine, Seoul National University 
      Hospital, Seoul 03080, Korea.
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PT  - Multicenter Study
DEP - 20160823
PL  - Korea (South)
TA  - Korean J Radiol
JT  - Korean journal of radiology
JID - 100956096
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aortic Dissection/*therapy
MH  - Brain Infarction/etiology
MH  - Embolization, Therapeutic/adverse effects/*methods
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Intracranial Aneurysm/*therapy
MH  - Male
MH  - Middle Aged
MH  - Recurrence
MH  - Retreatment/methods
MH  - Retrospective Studies
MH  - Risk Factors
MH  - *Stents
MH  - Treatment Outcome
MH  - Vertebral Artery
PMC - PMC5007409
OTO - NOTNLM
OT  - Aneurysm
OT  - Dissecting aneurysm
OT  - Posterior circulation
OT  - Stents
EDAT- 2016/09/03 06:00
MHDA- 2017/08/02 06:00
PMCR- 2016/09/01
CRDT- 2016/09/03 06:00
PHST- 2015/08/13 00:00 [received]
PHST- 2016/04/24 00:00 [accepted]
PHST- 2016/09/03 06:00 [entrez]
PHST- 2016/09/03 06:00 [pubmed]
PHST- 2017/08/02 06:00 [medline]
PHST- 2016/09/01 00:00 [pmc-release]
AID - 10.3348/kjr.2016.17.5.801 [doi]
PST - ppublish
SO  - Korean J Radiol. 2016 Sep-Oct;17(5):801-10. doi: 10.3348/kjr.2016.17.5.801. Epub 
      2016 Aug 23.