Purpose Vertebral artery dissecting aneurysms (VADA) are challenging disorders for neurosurgeons. Authors retrospectively evaluated our experience using endovascular techniques to treat these aneurysms.

Materials and methods Between July 2008 and December 2014, we treated 17 patients with dissecting aneurysms of the intracranial vertebral artery. Among them thirteen patients underwent endovascular treatment. Seven patients presented with subarachnoid hemorrhage from the ruptured aneurysm, another five presented with symptoms of abrupt severe headache and the other one with ischemia. The endovascular modalities were the following: 1) internal trapping (n = 7), 2) stent with coil (n = 2), 3) stent alone (n = 2), and 4) coil alone (n = 2).

Results There were no procedural complications following endovascular treatment. Clinical outcomes were favorable in 11 patients (84.6%). Initial neurological status was the main factor for the clinical outcome. No re-hemorrhages were observed in these patients during follow-up.

Conclusions Endovascular treatment, which includes several techniques, might be safe and effective strategy for patients with VADAs and can be the first choice for most patients. Risk can be managed by using appropriate endovascular techniques according to aneurysm location, configuration, and relationship with the posterior inferior cerebellar artery.

Disclosures D. Lim: None. S. Ha: None. J. Choi: None. S. Jin: None.