The management of vertebrobasilar dissecting aneurysm using endovascular embolization

To explore the imaging features of the vertebrobasilar artery dissecting aneurysm (VBA-DA) and to evaluate the effect of endovascular treatments. Five patients with VBA-DA undergoing endovascular treatments were retrospectively studied. Stent-alone technique was used to treat two of the patients, stent-assisted coil embolization of aneurysm in one patient, coil embolization of parent artery in the other patient, and stent-assisted coil embolization of parent artery in the last patient. Postoperative angiography revealed complete occlusion of aneurysm in two patients and delayed image development in three patients. One patient suffered postoperative cerebral hemorrhage without any neurological deficits. Five patients achieved favorable outcomes on both the imaging results and clinical recovery during a mean follow-up of 20.2 months (range 6-90 months). The string sign pearl and string sign and double-lumen sign are typical imaging features of VBA-DA. Treatment modality is determined by the imaging results. Endovascular embolization is a minimally-invasive, safe, effective, and reliable intervention for managing VBA-DA.