PubMed · 8418367
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T Ito, H Suda. 1993. [Aortic dissection].. https://pubmed.ncbi.nlm.nih.gov/8418367/
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We describe the management of residual dissection protruding through the struts of a Wiktor stent (Medtronic Inc., Minneapolis, MN) implanted in bailout conditions. In general, negotiating a stent through an expanded Wiktor stent is not recommended, but using this strategy, an AVE (Advanced Vascular Engineering, Santa Clara, CA) Micro stent was successfully implanted inside the Wiktor stent, leading to an excellent final angiographic result.
Late coronary aneurysm formation was observed following treatment by directional coronary atherectomy. Intravascular ultrasound disclosed that the mechanism involved was plaque rupture. The cause of coronary aneurysm may be multifactorial after coronary interventions. Intravascular ultrasound imaging is useful for understanding the pathologic mechanism of coronary aneurysm production.
Dissecting aneurysm of the basilar artery is a rare but increasingly recognized entity, with a frequently fatal or morbid outcome. Unlike the well established proximal occlusion and trapping approaches to vertebral artery dissections, surgical intervention for basilar lesions has been limited to wrapping techniques for arterial wall reinforcement. We report a case of midbasilar dissecting aneurysm successfully treated by clipping the proximal basilar artery below the level of the anterior inferior cerebellar arteries, allowing retrograde flow via the posterior communicating arteries to provide continued basilar perfusion. With the growing recognition of basilar dissection and pseudoaneurysm formation there is a need for improved therapeutic options. We suggest that definitive treatment can be achieved using the principle of proximal occlusion and flow reversal, and review the pertinent literature on basilar artery dissection.