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Journal of Korean Neurosurgical Society 2007;41(5): 318-322.
Bilateral Vertebral Artery Dissecting Aneurysms: A Long Term Follow-up Results of Microsurgical Trapping and Proximal Occlusion.
Young June Kim, Sang Youl Lee, Woo Tack Rhee, Yeon Gyu Jang
Department of Neurosurgery, Gangneung Asan Hospital, College of Medicine, Ulsan University, Gangneung, Korea. sylee@gnah.co.kr
ABSTRACT
Regarding the bilateral vertebral artery (VA) dissecting aneurysms, treatment strategy remains controversial because there have not been enough cases to reach a conclusion on the best treatment. We present a patient underwent staged microsurgical trapping and endovascular coiling for each dissecting aneurysm of bilateral VA presenting subarachnoid hemorrhage (SAH). The ruptured side was managed by VA trapping procedure without any neurological deficit. Postoperative cerebral angiography revealed patent right PICA without filling of previous right dissecting aneurysm and spontaneous occlusion of the left dissecting aneurysm one month after trapping procedure. However, follow-up angiography revealed recanalization and growing of the left VA dissecting aneurysm one year after the operation. The patient underwent endovascular embolization using GDC for the proximal occlusion of the left VA and postoperative course was uneventful.
Key Words: Bilateral; Dissecting; Aneurysm; Vertebral artery
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