{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T02:01:18Z","timestamp":1773712878528,"version":"3.50.1"},"reference-count":33,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2009,7]]},"abstract":"\nObject<\/jats:title>\nA ruptured dissecting aneurysm of the vertebrobasilar artery (VBA-DA) is a well-known cause of acute subarachnoid hemorrhage (SAH) with a high rate of early rebleeding. Internal trapping of the parent artery, including the dissected segment, is one of the most reliable techniques to prevent rebleeding. However, for a ruptured VBA-DA not suitable for internal trapping, the optimal treatment method has not been well established. The authors describe their experience in treating ruptured VBA-DAs not amenable to internal trapping of the parent artery with stent-assisted coil embolization (SAC) followed by a stent-within-a-stent (SWS) technique.<\/jats:p><\/jats:sec>\n\nMethods<\/jats:title>\nEleven patients\u20146 men and 5 women with a mean age of 48 years and each with a ruptured VBA-DA not amenable to internal trapping of the parent artery\u2014underwent an SAC-SWS between November 2005 and October 2007. The feasibility and clinical and angiographic outcomes of this combined procedure were retrospectively evaluated.<\/jats:p><\/jats:sec>\n\nResults<\/jats:title>\nThe SAC-SWS was successful without any treatment-related complications in all 11 patients. Immediate posttreatment angiograms revealed complete obliteration of the DA sac in 3 patients, near-complete obliteration in 7, and partial obliteration in 1. One patient died as a direct consequence of the initial SAH. All 10 surviving patients had excellent clinical outcomes (Glasgow Outcome Scale Score 5) without posttreatment rebleeding during a follow-up period of 8\u201324 months (mean follow-up 15 months). Angiographic follow-up at 6\u201312 months after treatment was possible at least once in all surviving patients. Nine VBA-DAs showed complete obliteration; the other aneurysm, which had appeared partially obliterated immediately after treatment, demonstrated progressive obliteration on 2 consecutive follow-up angiography studies. There was no in-stent stenosis or occlusion of the branch or perforating vessels.<\/jats:p><\/jats:sec>\n\nConclusions<\/jats:title>\nThe SAC-SWS technique seems to be a feasible and effective reconstructive treatment option for a ruptured VBA-DA. The technique may be considered as an alternative therapeutic option in selected patients with ruptured VBA-DAs unsuitable for internal trapping of the parent artery.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2009.2.jns081418","type":"journal-article","created":{"date-parts":[[2009,3,30]],"date-time":"2009-03-30T12:24:22Z","timestamp":1238415862000},"page":"48-52","source":"Crossref","is-referenced-by-count":60,"title":["Stent-assisted coil embolization followed by a stent-within-a-stent technique for ruptured dissecting aneurysms of the intracranial vertebrobasilar artery"],"prefix":"10.3171","volume":"111","author":[{"given":"Sang Hyun","family":"Suh","sequence":"first","affiliation":[{"name":"Department of Radiology, Yonsei University College of Medicine, Severance Hospital, Seoul;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Byung Moon","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Radiology, Yonsei University College of Medicine, Severance Hospital, Seoul;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sung Il","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Radiology, Soonchunhyang University, Bucheon Hospital, Bucheon;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong Ik","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Radiology, Yonsei University College of Medicine, Severance Hospital, Seoul;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong Sam","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Catholic University College of Medicine;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eui Jong","family":"Kim","sequence":"additional","affiliation":[{"name":"Departments of Radiology and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eun Chul","family":"Chung","sequence":"additional","affiliation":[{"name":"Departments of Radiology and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun Seok","family":"Koh","sequence":"additional","affiliation":[{"name":"Neurosurgery, Kyung Hee University College of Medicine; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyun Cheol","family":"Shin","sequence":"additional","affiliation":[{"name":"Neurosurgery, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chun Sik","family":"Choi","sequence":"additional","affiliation":[{"name":"Neurosurgery, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu Sam","family":"Won","sequence":"additional","affiliation":[{"name":"Neurosurgery, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"2","key":"b1-1110048","series-title":"Neurosurg Focus","first-page":"E3","article-title":"Endovascular management of intracranial vertebral artery dissecting aneurysms","volume":"18","author":"Albuquerque","year":"2005"},{"key":"b2-1110048","series-title":"Neurosurgery","first-page":"289","article-title":"Treatment of hemorrhagic intracranial dissections","volume":"53","author":"Anxionnat","year":"2003"},{"key":"b3-1110048","series-title":"AJNR Am J Neuroradiol","first-page":"1844","article-title":"Treatment of a ruptured dissecting vertebral artery aneurysm with double stent placement: case report","volume":"22","author":"Benndorf","year":"2001"},{"key":"b4-1110048","series-title":"Invest Radiol","first-page":"95","article-title":"Vascular responses in normal canine carotid arteries: comparison between various self-expanding stents of the same unconstrained size","volume":"38","author":"Cha","year":"2003"},{"key":"b5-1110048","series-title":"J Neurosurg","first-page":"150","article-title":"Double-stent method: therapeutic alternative for small wide-necked aneurysms. 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