OBJECTIVE AND IMPORTANCE: Dissecting @entity438 are increasingly recognized as a cause of @entity510 . We present a case involving technical success of the stent-supported coil embolization but with recurrence of the dissecting @entity2849 of the intracranial vertebral artery. The implications for the endovascular management of ruptured dissecting @entity2849 of the intracranial vertebral artery are discussed. CLINICAL PRESENTATION: A 36-year-old @entity1 with a remote history of @entity542 had recovered functionally to the point of independent living. He experienced the spontaneous onset of severe head and @entity4048 , which progressed rapidly to obtundation. A computed tomographic scan of the head revealed @entity510 centered in the posterior fossa. The @entity1 underwent cerebral angiography, which revealed @entity384 consistent with a dissecting @entity2849 . INTERVENTION: Transfemoral access was achieved under general anesthesia, and two overlapping stents (3 mm in diameter and 14 mm long) were placed to cover the entire dissected segment. Follow-up angiography of the left vertebral artery showed the placement of the stents across the neck of the @entity439 ; coil placement was satisfactory, with no residual @entity439 . Approximately 6 weeks after the @entity1 's initial presentation, he developed the sudden onset of severe @entity4048 . A computed tomographic scan showed no @entity510 , but computed tomographic angiography revealed that the previously treated left @entity438 had recurred. Angiography confirmed a recurrent @entity2849 around the previously placed Guglielmi detachable coils. A test balloon occlusion was performed for 30 minutes. The @entity1 's neurological examination was stable throughout the test occlusion period. Guglielmi detachable coil embolization of the left vertebral artery was then performed, sacrificing the artery at the level of the dissection. After the procedure was completed, no new @entity51 occurred. On the second day after the procedure, the @entity1 was discharged from the hospital. He was alert, oriented, and able to walk. CONCLUSION: We appreciate the value of preserving a parent vessel when a dissecting @entity7244 in @entity1 with inadequate collateral blood flow, in @entity1 with disease involving the contralateral vertebral artery, or in @entity1 with both. However, our case represents a cautionary note that @entity1 treated in this fashion require close clinical follow-up. We suggest that parent vessel occlusion be considered the first option for treatment in @entity1 who will tolerate sacrifice of the parent vessel along its diseased segment. In the future, covered stent technology may resolve this dilemma for many of these @entity1 .

Recurrence of a vertebral artery dissecting XXXX after successful stent-supported coil embolization: case report.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'man'] @entity510 :: ('MESH:D013345', 'Disease') :: ['subarachnoid hemorrhage'] @entity384 :: ('MESH:D002311', 'Disease') :: ['dilation of the distal left vertebral artery'] @entity542 :: ('MESH:D006259', 'Disease') :: ['head injury'] @entity7244 :: ('MESH:D020765', 'Disease') :: ['pseudoaneurysm of the intracranial vertebral artery ruptures'] @entity51 :: ('MESH:D009461', 'Disease') :: ['neurological deficits'] @entity4048 :: ('MESH:D019547', 'Disease') :: ['neck pain'] @entity439 :: ('MESH:D000783', 'Disease') :: ['aneurysm filling', 'aneurysm'] @entity2849 :: ('MESH:D017541', 'Disease') :: ['pseudoaneurysm', 'pseudoaneurysms'] @entity438 :: ('MESH:D002532', 'Disease') :: ['vertebral artery aneurysm', 'aneurysms of the intracranial vertebral artery']
@entity2849 :: (MESH:D017541,Disease) :: ['pseudoaneurysm']
