Endovascular treatment of ruptured dissecting aneurysms aimed at occlusionof the dissected site by using Guglielmi detachable coils

Object. Surgical or endovascular occlusion of the parent artery proximal to an aneurysm has been recommended for treatment of dissecting aneurysms of the intracranial posterior circulation. However, dissecting aneurysms may r upture even after proximal occlusion because distal progression of thrombus is necessary to occlude the dissecting aneurysm completely, and this may b e delayed by the presence of retrograde flow. In this article the authors p resent their experience in treating six patients with ruptured dissecting a neurysms. Methods. The authors report on six patients with a ruptured dissecting aneu rysm in the posterior fossa who were successfully treated by endovascular o cclusion of the aneurysm by using Guglielmi detachable coils. The procedure was particularly aimed at occluding the dissected site. Conclusions. At the present time, endovascular occlusion of the dissected s ite is a safe, minimally invasive, and reliable treatment for dissecting an eurysms when a test occlusion is tolerated and adequate collateral circulat ion is present.