{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T13:41:37Z","timestamp":1781271697654,"version":"3.54.1"},"reference-count":26,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J NeuroIntervent Surg"],"accepted":{"date-parts":[[2021,4,16]]},"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The ideal treatment for unruptured vertebral artery dissecting aneurysms (VADAs) and ruptured dominant VADAs remains controversial. We report our experience in the management and endovascular treatment of patients with VADAs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients treated endovascularly for intradural VADAs at a single institution from January 1, 1999, to December 31, 2019, were retrospectively reviewed. Primary neurological outcomes were assessed using modified Rankin Scale (mRS) scores, with mRS &gt;2 considered a poor neurological outcome. Additionally, any worsening (increase) in the mRS score from the preoperative neurological examination was considered a poor outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ninety-one patients of mean (SD) age 53 (11.6) years (48 (53%) men) underwent endovascular treatment for VADAs. Fifty-four patients (59%) presented with ruptured VADAs and 44 VADAs (48%) involved the dominant vertebral artery. Forty-seven patients (51%) were treated with vessel sacrifice of the parent artery, 29 (32%) with flow diversion devices (FDDs), and 15 (17%) with stent-assisted coil embolization (stent\/coil). Rates of procedural complications and retreatment were significantly higher with stent\/coil treatment (complications 4\/15; retreatment 6\/15) than with vessel sacrifice (complications 1\/47; retreatment 2\/47) or FDD (complications 2\/29; retreatment 4\/29) (p=0.008\u2009and p=0.002, respectively). Of 37 patients with unruptured VADAs treated, only two (5%) had mRS scores &gt;2 on follow-up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Endovascular FDD treatment of VADAs appears to be associated with lower retreatment and complication rates than stenting\/coiling, although further study is required for confirmation. Endovascular treatment of unruptured VADAs was safe and was associated with favorable angiographic and neurological outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1136\/neurintsurg-2020-017089","type":"journal-article","created":{"date-parts":[[2021,4,27]],"date-time":"2021-04-27T18:56:06Z","timestamp":1619549766000},"page":"257-261","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":37,"title":["Endovascular treatment of vertebral artery dissecting aneurysms : a 20-year institutional experience"],"prefix":"10.1136","volume":"14","author":[{"given":"Joshua S","family":"Catapano","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6670-5607","authenticated-orcid":false,"given":"Andrew F","family":"Ducruet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan 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