Flow diverter implantation for CTA-negative giant vertebral artery dissection aneurysm: a case report
Year: 2025
Type: article
Study design: Case Report
Abstract: Objective: To evaluate the efficacy of flow diverter implantation for treating CTA-negative giant vertebral artery dissection aneurysm (VADA) and to address the challenges in lesion characterization using MRI. Methods: A 66-year-old male patient presented with a 3-month history of left facial numbness and dysarthria. Initial MRI-T1 revealed a mixed signal intensity lesion in the CPA region. However, both CTA and digital subtraction angiography (DSA) failed to identify any significant vascular abnormalities. Subsequently, CT-perfusion and dynamic contrast-enhanced computed tomography (DCE-CT) were performed to further characterize the lesion. Results: DCE-CT revealed a giant VADA, which was significantly larger than the lesion initially detected by MRI and was identified as the cause of hypoperfusion in the posterior circulation. Based on these findings, a flow diverter implantation procedure was performed successfully without complications. Angiographic follow-up at 8 months demonstrated no recurrence of the lesion. At the 14-month clinical follow-up, the patient exhibited complete resolution of symptoms, with a mRS score of 0, indicating an excellent functional outcome. Conclusion: Flow diverter implantation may be an effective treatment for CTA-negative giant VADAs. The limitations of MRI in accurately characterizing lesion size underscore the necessity of advanced imaging techniques, such as DCE-CT, for precise device selection and deployment.
Source: Frontiers in Radiology
Authors: Jun-Ting Li, Jian-Min Liu, Kai-Jun Zhao
Institutions: Tongji University, Shanghai East Hospital, Changhai Hospital
Language: English
Subfield: Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,353
OpenAlex ID: W4417311512