Ruptured Vertebral Artery Dissecting Aneurysms Treated with Endovascular Treatment

Intracranial vertebral artery (VA) dissecting aneurysms often present with severe subarachnoid hemorrhage (SAH) and a subsequent high rate of mortality. We retrospectively studied the treatment efficacy and outcomes of 26 patients with ruptured VA dissecting aneurysms treated with endovascular surgery. Twenty-six patients with ruptured VA dissecting aneurysms were enrolled. Fifteen patients presented with poor-grade SAH and eleven with good-grade SAH. All patients were treated with endovascular treatment. We reviewed modes of therapy, complications and clinical outcomes. Coil occlusion of the artery at the dissecting aneurysm was performed in 24 patients. Proximal parent artery occlusion was performed in 2 patients. Obliteration of the dissecting aneurysm on postoperative angiogram was found in all patients. No patient sustained permanent complications associated with endovascular treatment. Regarding clinical outcome, although five patients died due to severe SAH, 19 patients had a good recovery or moderate disability. Ruptured VA dissecting aneurysms can be managed safely with coil occlusion of the lesion and/or parent artery.