We evaluated the cases of 32 consecutive patients with ruptured vertebral artery dissecting aneurysm (VADA) treated in our institution during the last 4 years. The goal of treatment was to exclude the aneurysm from the circulation using Guglielmi detachable coils (GDC). Twenty-six out of 32 patients were treated within 24 hours of the initial rupture, but 17 had rebleeding before treatment.
The outcome of the patients depended greatly on the patient's condition (Hunt & Kosnik grade) before treatment and whether there was rebleeding. There were 4 complications including 1 case of intra-operative rupture, 2 cases of rebleeding after treatment, and 1 case of cerebral infarction. The lessons from these complications would benefit from further treatment.
Although this report does not describe a controlled study, we found that endovascular treatment is preferable for treating ruptured VADAs in the acute stage.