Endovascular Treatment for Intracranial Artery Dissections in Posterior Circulation

Area of Science:

• Neurology
• Vascular Surgery
• Interventional Radiology

Background:

• Intracranial artery dissections (IADs) are a significant cause of stroke and hemorrhage.
• Posterior circulation IADs are more common and prone to hemorrhage than anterior circulation IADs.
• Current treatment for IADs lacks randomized controlled trial data, often relying on empirical approaches.

Purpose of the Study:

• To review the current literature on neuroendovascular treatment (EVT) for intracranial artery dissections in the posterior circulation.
• To provide an overview of EVT strategies, including deconstructive and reconstructive techniques.
• To highlight the emerging role and challenges of reconstructive EVT for ruptured posterior circulation IADs.

Main Methods:

• Literature search for studies on EVT in posterior circulation IADs.
• Analysis of EVT strategies, focusing on deconstructive versus reconstructive techniques.
• Review of reported outcomes and efficacy of different EVT approaches.

Main Results:

• EVT is increasingly utilized for IADs due to its minimally invasive nature and efficacy.
• Reconstructive EVT techniques are gaining attention, with a growing number of reports.
• Established reconstructive techniques for ruptured posterior circulation IADs are still lacking.

Conclusions:

• EVT represents a viable treatment option for posterior circulation IADs.
• Reconstructive EVT techniques offer potential for preserving parent vessel flow in IAD management.
• Further research and development of standardized reconstructive techniques are needed for ruptured IADs.