Combined Stent Therapy for Ruptured Dissecting Aneurysms in the Posterior Circulation

Lisa Fukrey^*
*Correspondence: Lisa Fukrey, Department of Neurosurgery, Voino-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk 660022, Russia, Email:

Introduction

Intracranial dissecting aneurysms, characterized by the separation of arterial wall layers, pose a significant threat to neurological health, often leading to severe consequences if left untreated. The posterior circulation of the brain, which includes the vertebrobasilar system, is a common site for these aneurysms to occur, potentially causing subarachnoid hemorrhage and ischemic strokes [1]. The management of ruptured dissecting aneurysms in the posterior circulation is complex, requiring a careful balance between preventing re-bleeding and maintaining adequate blood flow. Recent advances in neurointerventional techniques have introduced a combined stent therapy approach, involving the deployment of a stent in conjunction with traditional endovascular procedures, such as coiling or flow diversion, to address these challenging aneurysms. This paper explores the utilization of combined stent therapy for the treatment of ruptured dissecting aneurysms in the posterior circulation, shedding light on the rationale, procedural nuances and clinical outcomes associated with this evolving approach [2].

Description

Dissecting aneurysms in the posterior circulation present unique challenges due to their location and the potential for both subarachnoid hemorrhage and ischemic events. In cases of rupture, the risk of re-bleeding or ischemic complications necessitates prompt intervention [3]. Traditional endovascular methods such as coiling and flow diversion can effectively address aneurysms; however, in certain cases, they may be less suitable for dissecting aneurysms with their fragile and fragile arterial walls. Combined stent therapy represents an innovative approach to tackle ruptured dissecting aneurysms in the posterior circulation. It involves the placement of a stent alongside traditional endovascular techniques. The stent serves multiple purposes in this context: first, it acts as a scaffold to support the vessel wall, reducing the risk of rebleeding; second, it redirects blood flow away from the aneurysm, minimizing the risk of further dissection and rupture; and third, it facilitates the placement of coils, effectively promoting aneurysm occlusion. The stent chosen for this approach can be a self-expanding stent or a flow-diverting stent, depending on the specifics of the case and the anatomical characteristics of the aneurysm. The choice of stent, its size and the techniques used for deployment are crucial factors in the success of the procedure. Furthermore, antiplatelet agents are often administered to prevent thromboembolic complications associated with stent placement [4,5].

Conclusion

The utilization of combined stent therapy for ruptured dissecting aneurysms in the posterior circulation represents a promising and evolving approach in the field of neurointervention. By combining the mechanical support and hemodynamic alterations provided by stent deployment with traditional endovascular methods, this strategy addresses the multifaceted challenges posed by these complex aneurysms. The key to the success of combined stent therapy lies in careful patient selection, precise stent placement and close post-procedural monitoring. Clinical outcomes and studies exploring the effectiveness and safety of this approach have shown promise, but ongoing research is essential to further define its scope and limitations. In conclusion, combined stent therapy offers a potential game-changer in the management of ruptured dissecting aneurysms in the posterior circulation. This approach, when executed with expertise and patient-tailored precision, holds the potential to improve patient outcomes, reduce re-bleeding and ischemic complications and enhance the treatment landscape for these challenging vascular lesions. As our understanding of this technique continues to evolve, it offers hope for better prognoses and enhanced care for patients suffering from ruptured dissecting aneurysms in the posterior circulation.

References

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