Changes in Vertebrobasilar Artery Dissection Visible with High-Resolution Vessel Wall Imaging: A Serial Follow-Up...

Area of Science:

• Neurology
• Radiology
• Vascular Imaging

Background:

• Vertebrobasilar artery dissections (VBADs) are identifiable with high-resolution vessel wall imaging (HR-VWI).
• While VBADs are clinically benign, their serial changes on HR-VWI remain uncharacterized.

Purpose of the Study:

• To evaluate the longitudinal changes in VBADs using HR-VWI.
• To understand the natural course of VBADs through serial imaging follow-up.

Main Methods:

• Retrospective enrollment of patients with symptomatic VBADs and initial/follow-up HR-VWI.
• Serial HR-VWI follow-up at 3, 6, 12, and 24 months post-symptom onset.
• Classification of follow-up findings into wall thickness (type 1), no change (type 2), or occlusion (type 3).

Main Results:

• Fifteen patients (median age 50) were analyzed, all initially showing intimal flaps and double lumens.
• During follow-up, 60% showed wall thickening (type 1), 33.3% had no interval change (type 2), and one had occlusion (type 3).
• Nine patients (60%) demonstrated healing, characterized by intimal flap attachment to the vessel wall.

Conclusions:

• VBADs exhibit dynamic changes detectable by HR-VWI during follow-up.
• The majority of VBADs demonstrate a healing process, including resolution of intimal flaps and double lumens.