Article Figures & Data
Figures
- FIG 1.
Artistic illustration of the inclusion criteria: VBDA involving the basilar artery (A), and VBDA involving both basilar and vertebral arteries (B) with superimposed dilation of a portion of the arterial segment. Artistic illustration of the exclusion criteria: A VBDA presenting with only elongation and/or tortuosity but without ectasia (C), and a VBDA only involving only the vertebral artery (D). The pictures are drawn by courtesy of Dr Jian Ren.
- FIG 2.
Preoperative DSA (A) and MR imaging (B) showing a VBDA and mild brainstem compression (red arrow). Angiography (C) after 2 LEO stents were implanted (blue arrow). Two-year follow-up DSA (D) indicating partial occlusion of the VBDA lesion (blue arrow), with MR imaging (E) revealing progressive brainstem compression (red arrow). Five-year follow-up DSA (F) showing further angiographic occlusion of the VBDA lesion (blue arrow), with MR imaging (G) revealing obvious progression of brainstem compression (red arrow).
- FIG 3.
Preoperative DSA (A) showing a VBDA, with MR imaging (B) indicating no obvious brainstem compression. Angiography (C) after endovascular treatment with 2 Pipeline Embolization Devices was conducted. The blue arrows point to the proximal and distal edges of the first 5 × 35 cm Pipeline Embolization Device. The red arrows point to the proximal and distal edges of the second 5 × 35 cm Pipeline Embolization Device. Nine-month follow-up DSA (D) shows good healing of the dilation (black arrow) with no obvious progression of compression on MR imaging (E).
Tables
Factors Different Groups LPBS (n = 25) FD (n = 22) P Value Patient characteristics Age (mean) (yr) 58.6 (SD, 10.2) 59.4 (SD, 8.7) .445 Sex (male) 21 (84%) 17 (77.3%) .654 Medical history Hypertension 23 (92%) 19 (86.4%) .532 Diabetes 4 (16%) 1 (18.2%) .204 Smoking 10 (40%) 8 (36.4%) .798 Preoperative mRS score 0 4 (16%) 5 (22.7%) .582 1 10 (40%) 5 (22.7%) 2 8 (32%) 9 (40.9%) 3 3 (12%) 2 (9.1%) 4 0 1 (4.6%) 5 0 0 VBDA imaging characteristic Length of VBDA (mean) (mm) 33.6 (SD, 11.9) 38.4 (SD, 13.8) .551 Diameter of VBDA (mean) (mm) 15.2 (SD, 5.1) 15.4 (SD, 5.2) .924 Brainstem compression resulting from VBDA 13 (52%) 13 (59.1%) .626 Cerebral infarction around VBDA territory 7 (28%) 9 (40.9%) .351 Factors Different Groups LPBS (n = 25) FD (n = 22) P Value Safety results Clinical outcomea Good (mRS ≤2) 14 (56%) 13 (59.1%) .831 Poor (mRS 2) 11 (44%) 9 (40.9%) Changes in symptoms Nonaggravated 13 (52%) 14 (63.6%) .421 Aggravated 12 (48%) 8 (36.4%) New neurologic deficits due to procedural complications Total 6 (24%) 9 (40.9%) .215 Hemorrhagic 1 (4%) 2 (9.1%) .476 Ischemic 5 (20%) 9 (40.9%) .118 Mild-to-severe disability 6 (24%) 6 (27.3%) .861 Neurologic death 3 (12%) 2 (9.1%) .747 Efficacy results Angiographic occlusionb Complete 2 (10%) 7 (41.2%) .028 Near-complete 12 (60%) 7 (41.2%) .254 Incomplete 6 (30%) 3 (17.6%) .383 Progression of mass effect Nonprogressed 10 (50%) 12 (70.6%) .204 Progressed 10 (50%) 5 (29.4%) ↵a Clinical follow-up data were available for all 47 of the 47 patients included.
↵b Radiologic imaging follow-up data for evaluating angiographic occlusion and progression of mass effect was available for 37 of the 47 patients included, 20 of the 25 patients in LPBS group and 17 of the 22 patients in FD group. Three surviving patients were lost to radiologic imaging follow-up due to poor status.
