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Altered hemodynamics associated with pathogenesis of the vertebral artery dissecting aneurysms

Akira Kurata1, Sachio Suzuki, Kazuhisa Iwamoto

  • 1Department of Neurosurgery, Kitasato University School of Medicine, Kanagawa 228-8555, Japan.

Stroke Research and Treatment
|May 3, 2012
PubMed

Insights

Turbulent blood flow may cause vertebral artery dissection aneurysms, often near vessel curves or unions. This finding is crucial for developing effective treatment strategies for these rare conditions.

Area of Science:

  • Vascular Surgery
  • Neurology
  • Radiology

Background:

  • Vertebral artery dissections (VADs) are poorly understood, predominantly affecting young, healthy males.
  • The anatomical variations and hemodynamic factors contributing to VAD etiology remain unclear.

Purpose of the Study:

  • To investigate the anatomical characteristics and hemodynamic patterns associated with vertebral artery dissections.
  • To identify potential etiological factors contributing to the development of VADs.

Main Methods:

  • Retrospective analysis of 57 consecutive VAD cases diagnosed via angiography.
  • Classification of vertebral artery (VA) deviation into three types (I, II, III).
  • Hemodynamic assessment in 12 recent cases using angiography to evaluate contrast material flow into the pseudolumen.

Main Results:

  • Type III VA deviation was most common on the affected side, often occurring proximal to a tortuous segment.
  • Dissections on the non-dominant side (10/57) were predominantly Type I or II.
  • Eleven of 12 patients exhibited retrograde contrast inflow into the pseudolumen, with turbulent blood flow observed in all.

Conclusions:

  • Turbulent blood flow is a significant etiological factor in vertebral artery dissection aneurysms.
  • Dissection sites are frequently located proximal to vessel tortuosity or unions.
  • Retrograde inflow is more common in dissections near tortuous VAs, influencing therapeutic strategy design.

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