Endovascular intervention of intradural hemorrhage from ruptured spontaneous vertebral artery dissection

OBJECTIVE: To study the therapeutic effect of endovascular treatment for intradural hemorrhage from ruptured spontaneous vertebral artery dissections (SVAD) using Guglielmi detachable coils and mechanical coils.

METHODS: The retrospective study was carried out in the Department of Interventional Radiology, Rizhao People’s Hospital, Rizhao, China from January 2008 to December 2011. Twelve patients with intradural hemorrhage from ruptured SVAD underwent endovascular embolization treatment after imaging and clinical evaluation. The aneurysm lumen and the parent artery were embolized with Guglielmi detachable coils and mechanical coils. Guglielmi detachable coils were used to embolize the aneurysm lumen and the parent artery adjacent to the aneurysm. Mechanical coils were used to embolize the parent artery.

RESULTS: All lesions were proximal to the posterior inferior cerebellar artery origin. All patients had successful outcomes without any other complications. Angiograms immediately after embolization demonstrated complete occlusions. There were no patient deaths during the study. All cases resulted in complete occlusions, and no rebleeding or ischemia occurred during the 6-36 month follow-up period.

CONCLUSION: Endovascular intervention with Guglielmi detachable coils and mechanical coils is a safe and efficacious method for treating intradural hemorrhage from ruptured SVAD.