Endovascular Treatment of Intracranial Artery Dissection: Clinical and Angiographic Follow-Up
Background. Intracranial artery dissections are rare and many controversies exist about treatment options. The aim of this study was to evaluate the efficacy and safety of the endovascular approach in patients with an intracranial dissection presenting with different symptoms. Methods. We prospectiv...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | Neurology Research International |
| Online Access: | http://dx.doi.org/10.1155/2013/968380 |
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| author | Reza Mohammadian Ali Akbar Taheraghdam Ehsan Sharifipour Reza Mansourizadeh Ali Pashapour Mohammad Shimia Ghaffar Shokouhi Moslem shakeri Ali Hashemzadeh |
| author_facet | Reza Mohammadian Ali Akbar Taheraghdam Ehsan Sharifipour Reza Mansourizadeh Ali Pashapour Mohammad Shimia Ghaffar Shokouhi Moslem shakeri Ali Hashemzadeh |
| author_sort | Reza Mohammadian |
| collection | DOAJ |
| description | Background. Intracranial artery dissections are rare and many controversies exist about treatment options. The aim of this study was to evaluate the efficacy and safety of the endovascular approach in patients with an intracranial dissection presenting with different symptoms. Methods. We prospectively evaluated the clinical features and treatment outcomes of 30 patients who had angiographically confirmed nontraumatic intracranial dissections over 4 years. Patients were followed up for 17 months, and their final outcomes were assessed by the modified Rankin Score (mRS) and angiography. Results. Sixteen (53.3%) patients had a dissection of the anterior circulation, whereas 14 (46.7%) had a posterior circulation dissection. Overall, 83.3% of the patients suffered a subarachnoid hemorrhage (SAH). Grade IV Hunt and Hess score was seen in 32% of the SAH presenting cases. Parent artery occlusion (PAO) with coil embolization was used in 70% of the cases. The prevalence of overall procedural complications was 23.3%, and all were completely resolved at the end of follow-up. No evidence of in-stent occlusion/stenosis or rebleeding was observed in our cases during follow-up. Angiography results improved more frequently in the PAO with coil embolization group (100%) than in the stent-only-treated group (88.9%) (P=0.310) and the unruptured dissection group (5/5, 100%) in comparison with the group that presented with SAH (95.8%) (P=0.833). Conclusion. Favorable outcomes were achieved following an endovascular approach for symptomatic ruptured or unruptured dissecting aneurysms. However, the long-term efficacy and durability of these procedures remain to be determined in a larger series. |
| format | Article |
| id | doaj-art-416ffa0e3d6b4a66a03934c5c65caf01 |
| institution | Kabale University |
| issn | 2090-1852 2090-1860 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Neurology Research International |
| spelling | doaj-art-416ffa0e3d6b4a66a03934c5c65caf012025-02-03T05:49:45ZengWileyNeurology Research International2090-18522090-18602013-01-01201310.1155/2013/968380968380Endovascular Treatment of Intracranial Artery Dissection: Clinical and Angiographic Follow-UpReza Mohammadian0Ali Akbar Taheraghdam1Ehsan Sharifipour2Reza Mansourizadeh3Ali Pashapour4Mohammad Shimia5Ghaffar Shokouhi6Moslem shakeri7Ali Hashemzadeh8Neuroscience Research Center, Tabriz University of Medical Sciences, P.O. Box 51665-348, Tabriz, IranNeuroscience Research Center, Tabriz University of Medical Sciences, P.O. Box 51665-348, Tabriz, IranNeuroscience Research Center, Tabriz University of Medical Sciences, P.O. Box 51665-348, Tabriz, IranNeurology and Neurosurgery Department, Alinasab Hospital, Tabriz, IranNeuroscience Research Center, Tabriz University of Medical Sciences, P.O. Box 51665-348, Tabriz, IranNeurosurgery Department, Tabriz University of Medical Sciences, Tabriz, IranNeurosurgery Department, Tabriz University of Medical Sciences, Tabriz, IranNeurosurgery Department, Tabriz University of Medical Sciences, Tabriz, IranNeurology and Neurosurgery Department, Alinasab Hospital, Tabriz, IranBackground. Intracranial artery dissections are rare and many controversies exist about treatment options. The aim of this study was to evaluate the efficacy and safety of the endovascular approach in patients with an intracranial dissection presenting with different symptoms. Methods. We prospectively evaluated the clinical features and treatment outcomes of 30 patients who had angiographically confirmed nontraumatic intracranial dissections over 4 years. Patients were followed up for 17 months, and their final outcomes were assessed by the modified Rankin Score (mRS) and angiography. Results. Sixteen (53.3%) patients had a dissection of the anterior circulation, whereas 14 (46.7%) had a posterior circulation dissection. Overall, 83.3% of the patients suffered a subarachnoid hemorrhage (SAH). Grade IV Hunt and Hess score was seen in 32% of the SAH presenting cases. Parent artery occlusion (PAO) with coil embolization was used in 70% of the cases. The prevalence of overall procedural complications was 23.3%, and all were completely resolved at the end of follow-up. No evidence of in-stent occlusion/stenosis or rebleeding was observed in our cases during follow-up. Angiography results improved more frequently in the PAO with coil embolization group (100%) than in the stent-only-treated group (88.9%) (P=0.310) and the unruptured dissection group (5/5, 100%) in comparison with the group that presented with SAH (95.8%) (P=0.833). Conclusion. Favorable outcomes were achieved following an endovascular approach for symptomatic ruptured or unruptured dissecting aneurysms. However, the long-term efficacy and durability of these procedures remain to be determined in a larger series.http://dx.doi.org/10.1155/2013/968380 |
| spellingShingle | Reza Mohammadian Ali Akbar Taheraghdam Ehsan Sharifipour Reza Mansourizadeh Ali Pashapour Mohammad Shimia Ghaffar Shokouhi Moslem shakeri Ali Hashemzadeh Endovascular Treatment of Intracranial Artery Dissection: Clinical and Angiographic Follow-Up Neurology Research International |
| title | Endovascular Treatment of Intracranial Artery Dissection: Clinical and Angiographic Follow-Up |
| title_full | Endovascular Treatment of Intracranial Artery Dissection: Clinical and Angiographic Follow-Up |
| title_fullStr | Endovascular Treatment of Intracranial Artery Dissection: Clinical and Angiographic Follow-Up |
| title_full_unstemmed | Endovascular Treatment of Intracranial Artery Dissection: Clinical and Angiographic Follow-Up |
| title_short | Endovascular Treatment of Intracranial Artery Dissection: Clinical and Angiographic Follow-Up |
| title_sort | endovascular treatment of intracranial artery dissection clinical and angiographic follow up |
| url | http://dx.doi.org/10.1155/2013/968380 |
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