Multiple stents dual-channel parallel placement technique for the treatment of giant vertebrobasilar dissecting aneurysms

LIANG Yongping; LI Sheng; CHEN Yakun; REN Bin; LI Baomin; SUN Zhenghui; SUN Junzhao; ZHANG Jianning

doi:10.3639/j.issn.1671-2897.2025.04.005

Abstract：Objective To explore the clinical feasibility,safety,and short-term follow-up results of the treatment of giant vertebral basilar artery dissection aneurysms involving both bilateral vertebral arteries and basilar arteries by using dual channel parallel placement of multiple intracranial self-expandable stents for aneurysm remodeling.Methods Four consecutive patients(men;mean age:54.8 years;range:51-63 years old)with giant vertebrobasilar dissecting aneurysms admitted to Chinese PLA General Hospital from January 2020 to June 2023 were retrospectively reviewed.All patients were diagnosed vertebrobasilar dissecting aneurysms by MRI and DSA,and were treated by multiple stents dual-channel parallel placement and reconstruction technique under general anesthesia.In the endovascular treatment process,Enterprise 2 or Neuroform EZ self-expandable stents were parallelly implanted in the maximum extension segment of the aneurysms.Based on the 2 stents,the vertebrobasilar dissecting areas were completely covered by telescope technique.The 4 patients were implanted 24 stents(1 patient with7 stents;2 patients with 6 stents respectively,and 1 patient with 5 stents)and received routine antiplatelet therapy before and after endovascular treatment.Results All 4 patients were successfully treated,with the signs and symptoms of brain stem and posterior group of cranial nerves improved significantly except 1 patient with postoperative facial paralysis.All patients lived and worked normally and had no recurrent symptoms on follow-up of 6-12 months.DSA reexamination on follow-up of 6-12 months showed that the aneurysm size lessened in 2 patients and had no change in the other 2.Conclusion Multiple stents dual-channel parallel placement and reconstruction technique for treating giant vertebrobasilar dissecting aneurysms is feasible and has good operation safety.It can control the dilatation of the aneurysm,reduce the probability of thrombosis or hemorrhage,and improve the patients'clinical symptoms and quality of life.