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Research ArticleINTERVENTIONAL

Stent-within-a-Stent Technique for the Treatment of Dissecting Vertebral Artery Aneurysms

Bharat Mehta, Tom Burke, Max Kole, Ali Bydon, Donald Seyfried and Ghaus Malik
American Journal of Neuroradiology October 2003, 24 (9) 1814-1818;
Bharat Mehta
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Tom Burke
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Max Kole
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Ali Bydon
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Donald Seyfried
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Ghaus Malik
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    Fig 1.

    Case 1. Angiograms in a 46-year-old right-handed woman with an SAH of Hunt-Hess grade II.

    A, Left VA injection image obtained at an outside institution. The right VA aneurysm (arrow) was missed because of the failure to perform an ipsilateral injection.

    B, Right VA ejection image (anteroposterior [AP] projection) shows dissection and pseudoaneurysm at the origin of the right PICA (bottom arrow). Top arrow indicates vasospasm in the distal VA.

    C, Right VA injection image (lateral oblique projection) shows a residual fusiform aneurysm. The area is protected by a stent, and the PICA is patent.

    D and E, Right VA injection images (lateral [D and E] projections) obtained 6 months after the stent-within-stent procedure shows complete healing of the aneurysm, with patency of the PICA and restoration of the normal caliber of the vessel.

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    Fig 2.

    Angiograms in a 54-year-old man with a history of hypertension and a sudden, severe occipital headache. He had SAH tracking into the ventricles (Hunt-Hess grade II, Fisher grade IV).

    A, Left VA injection image (oblique projection) demonstrates a fusiform irregular dissecting aneurysm at the origin of the left PICA.

    B, Left VA injection image obtained 6 months after the stent-within-a-stent procedure demonstrates partial resolution of the aneurysm with patency of the PICA.

    C (lateral) and D (oblique), Left VA injections images obtained 18 months after the stent-within-a-stent procedure demonstrate complete healing of the aneurysm with restoration of the normal lumen. The stent is across from the origin of the patent PICA.

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    Fig 3.

    Angiograms in a 52-year-old woman who was referred for evaluation of a left VA aneurysm. She was experiencing episodes of occipital headaches and neck pain associated with vertigo and dizziness.

    A, Left VA injection image (AP view) demonstrates a left VA intracranial aneurysm distal to the PICA origin.

    B, Left VA injection image demonstrates the stent-within-a-stent construct created with two Velocity stents in the left VA.

    C (AP view) and D (lateral view), Left VA injection images (AP and lateral views) demonstrate patency of the PICA and complete healing of the aneurysm, with restoration of the normal lumen of the left VA.

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American Journal of Neuroradiology: 24 (9)
American Journal of Neuroradiology
Vol. 24, Issue 9
1 Oct 2003
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Cite this article
Bharat Mehta, Tom Burke, Max Kole, Ali Bydon, Donald Seyfried, Ghaus Malik
Stent-within-a-Stent Technique for the Treatment of Dissecting Vertebral Artery Aneurysms
American Journal of Neuroradiology Oct 2003, 24 (9) 1814-1818;

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Stent-within-a-Stent Technique for the Treatment of Dissecting Vertebral Artery Aneurysms
Bharat Mehta, Tom Burke, Max Kole, Ali Bydon, Donald Seyfried, Ghaus Malik
American Journal of Neuroradiology Oct 2003, 24 (9) 1814-1818;
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Cited By...

  • Role of optical coherence tomography in pipeline embolization device for the treatment of vertebral-basilar artery dissecting aneurysms
  • Radical treatment of ruptured dissecting aneurysm on the P1 segment with monotherapy using multiple LVIS stents
  • Hemodynamic Changes Caused by Multiple Stenting in Vertebral Artery Fusiform Aneurysms: A Patient-Specific Computational Fluid Dynamics Study
  • Endovascular treatment of acute intracranial vertebral artery dissection: long-term follow-up results of internal trapping and reconstructive treatment using coils and stents
  • Multiple overlapping stents as monotherapy in the treatment of 'blister' pseudoaneurysms arising from the supraclinoid internal carotid artery: a single institution series and review of the literature
  • Stent usage in the treatment of intracranial aneurysms: past, present and future
  • Incidence and Risk Factors of Recurrence After Endovascular Treatment of Intracranial Vertebrobasilar Dissecting Aneurysms
  • Clinical and Angiographic Follow-Up of Stent-Only Therapy for Acute Intracranial Vertebrobasilar Dissecting Aneurysms
  • Mechanically-induced proximal arterial occlusion and stent-within-a-stent technique for the treatment of bilateral vertebral artery dissecting aneurysms.
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