Endovascular treatment of intracranial dissecting vertebral aneurysms using stenting-coiling technique

Dissecting aneurysms of the intracranial vertebral artery, represent a more frequently recognized cause of subarachnoid hemorrhage. The poor natural h istory of the ruptured dissecting ancurysms indicate a surgical or endovasc ular treatment. Endovascular treatment usually consists of balloon occlusio n of the vertebral artery. This treatment however can lead to hemodynamic c omplications especially when the treated artery, is unique or dominant. We report two cases of ruptured dissecting ancurysms of the intracranial verte bral artery, treated by intravascular stent and endosaccular GDC coils. The first patient suffered from bilateral dissection with spontaneous occlusio n of the right vertebral artery and development of a Pouch oil the left sid e. The second patient suffered from a dissection of the left vertebral arte ry, which was dominant. The stenting-coiling technique was efficient in the two cases. The patients are free of symptoms with a respective follow lip of 24 and 8 months, The stenting-coiling association seems to be an interes ting therapeutic option in case of intracranial dissecting ancurysms which allows a Preservation of the arterial flow and selective occlusion of thc a ncurysmal pouch.