Endovascular Reconstruction for Treatment of Vertebrobasilar Dolichoectasia: Long-Term Outcomes

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Fig. 1.
A, Anteroposterior position angiogram of the right vertebrobasilar artery depicts the VBD (white arrows) and a fusiform aneurysm (black arrow). B, Semideployed coil to assist 2 telescoping LEO stents deployed with the double-catheter technique. C, The coil is resheathed after stent deployment. D, The right vertebrobasilar artery lumen is smaller than that in A (CT angiography follow-up 24 months). Note the disappearance of the fusiform aneurysm.
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Fig. 2.
A, Anteroposterior position angiogram of the left vertebrobasilar artery depicts the VBD (white arrow) and aneurysmal arterial wall vesicles (black arrows). B, Angiogram immediately after overlapping stent deployment. C, Stents after the procedure. D, Angiographic follow-up 14 months after the procedure shows that the lumen of the basilar artery is thinner than that in A (white arrow) and the vesicles have disappeared (black arrows).

Clinical and imaging findings, treatment mode, and follow-up results of patients with VBD

Characteristics and Findings	Patient No.
Characteristics and Findings	1	2	3	4	5	6	7	8	9
Sex	F	M	M	M	M	M	M	M	F
Age (yr)	75	74	57	48	56	39	63	63	61
Cerebrovascular risk factors	HPN	HPN + HU	HPN + HPL + PK	HPN + S	HPN + A	S + A	HPN	HPN	HPN
Symptoms	Acute headache	Ischemia	Ischemia	Acute headache	Acute headache	Ischemia	Ischemia	Chronic headache	Ischemia
Intraluminal thrombosis	Yes (MRI)	Possible (CT)	Yes (MRI)	None	Possible (CT)	None	Yes (MRI)	Yes (MRI)	Yes (MRI)
Involved anterior circulation	Yes	Yes	None	None	Yes	None	None	None	Yes
Predominant VA	Yes (R)	Yes (L)	Bilateral	Yes (L)	Yes (L)	Yes (L)	Yes (R)	Yes (R)	Bilateral
Treatment mode	3 × LEO, 8 × coils, occlude L-VA l mo later	3 × LEO	6 × LEO, 7 × coils	5 × LEO	4 × LEO	3 × LEO	4 × LEO 1 × Solitaire	2 × LEO	4 × Solitaire, 2 × coils
mRS pre-op/post-op/FU (time, mo)	1st: 4/3/3 (1 mo); 2nd: 3/4/5 (28 mo)	3/2/5 (25 mo)	3/3/3 (17 mo)	1/1/0 (14 mo)	2/2/2 (18 mo)	3/3/Death (26 mo)	4/4/Death (4 mo)	1/1/0 (28 mo)	1/1/1 (10 mo)
Angiography FU (mo)	1 mo	23 mo (MRA)	8 mo (DSA)	13 mo (DSA)			8 days	24 mo (CTA)

Note:—HPN indicates hypertension; HU, hyperuricemia; HPL, hyperlipidemia; PK, polycystic kidney; S, smoking; A, alcohol; L, left; R, right; pre-op, pre-operation; post-op, immediately post-operation; FU, last follow-up after the operation.