Enlargement of Asymptomatic VA Dissecting Aneurysm after Initial Treatment with Stent-assisted Coil Embolization with Contra Lateral Ruptured VA Dissecting Aneurysm Treated by Parent Artery Occlusion: A Case Report

• Published in: Journal of Neuroendovascular Therapy 2019, Vol.13(6), pp.262-267
• Main Authors: Gaber, Karim, Ezura, Masayuki, Narisawa, Ayumi, Takahashi, Yusuke, Inoue, Takashi, Uenohara, Hiroshi
• Format: Article
• Language: English
• Subjects: bilateral vertebral artery; dissecting aneurysm; parent artery occlusion; stent-assisted coil embolization
• ISSN: 1882-4072; 2186-2494
• DOI: 10.5797/jnet.cr.2018-0126

Objective: A rare case of enlargement of asymptomatic dissecting aneurysm after its initial treatment with stent-assisted coiling with parent artery occlusion for the ruptured contra lateral side is reported.Case Presentation: A 52-year-old male patient presented with a subarachnoid hemorrhage resulting from a bilateral vertebral artery dissecting aneurysms. The patient was treated within 24 hours of the hemorrhage to prevent re-rupture by parent artery occlusion of the right vertebral artery and stent-assisted coiling of the left side. A 6-month follow-up showed an enlargement of the left side dissecting aneurysm. A second treatment was done to the left side also using stent-assisted coiling. The patient was discharged with no neurological deficit.Conclusion: To our knowledge, parent artery occlusion for ruptured vertebral artery dissecting aneurysms (VADA) may cause contra lateral VADA enlargement even after its initial treatment by stent-assisted coil embolization in the same setting.