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Case series
Role of optical coherence tomography in pipeline embolization device for the treatment of vertebral–basilar artery dissecting aneurysms
  1. Yongjie Ma1,2,
  2. Zhe Ji1,2,
  3. Wanxin Yang1,2,
  4. Li Li3,
  5. Liqiang Han4,
  6. Yu Liu4,
  7. Yuanhao Guo5,
  8. Adam A Dmytriw6,7,
  9. Chuan He1,2,
  10. Guilin Li1,2,
  11. Hongqi Zhang1,2
  1. 1Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
  2. 2China International Neuroscience Institute, Beijing, China
  3. 3Neurosurgery, Harbin Medical University Fourth Hospital, Harbin, China
  4. 4Software Engineering, Dalian University of Technology, Dalian, Liaoning, China
  5. 5Institute of Automation, Chinese Academy of Sciences Institute of Automation, Beijing, China
  6. 6Neuroendovascular Program, Massachusetts General Hospital, Boston, Massachusetts, USA
  7. 7Neuroradiology and Neurointervention, Brigham and Women's Hospital, Boston, Massachusetts, USA
  1. Correspondence to Dr Hongqi Zhang, Neurosurgery, Xuanwu Hospital, Capital Medical University, No.45 Changchun Street, Xicheng District, Beijing, China; xwzhanghq{at}


Background Vertebral–basilar artery dissecting aneurysms (VADAs) are an uncommon phenomenon in all fields of cerebrovascular disease. The flow diverter (FD) can be used as an endoluminal reconstruction device that promotes neointima formation at the aneurysmal neck and preserves the parent artery. To date, imaging examinations such as CT angiography, MR angiography, and DSA are the main methods used to evaluate the vasculature of patients. However, none of these imaging methods can reveal the situation of neointima formation, which is of great importance in evaluating occlusion of VADAs, especially those treated with a FD.

Methods Three patients were included in the study from August 2018 to January 2019. All patients underwent preprocedural, postprocedural, and follow-up evaluations with high resolution MRI, DSA, and optical coherence tomography (OCT), as well as the formation of intima on the surface of the scaffold at the 6 month follow-up.

Results Preprocedural, postoperative, and follow-up high resolution MRI, DSA, and OCT of all three cases successfully evaluated occlusion of the VADAs and occurrence of in stent stenosis from different views of intravascular angiography and neointima formation.

Conclusions OCT was feasible and useful to further evaluate VADAs treated with FD from a near pathological perspective, which may contribute toward guiding the duration of antiplatelet medication and early intervention of in stent stenosis.

  • Aneurysm
  • Intervention
  • Flow Diverter

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  • YM, ZJ and WY contributed equally.

  • GL and HZ contributed equally.

  • Contributors YM, ZJ, and WY drafted the original and revised the manuscript. LL collected the data. LH, YL, and YG processed the images and reconstructed the three-dimensional model. AAD and CH accepted our consultation as an expert and guided the revision. GL and HZ designed the work and reviewed the manuscript.

  • Funding This study was funded by the National Key Research Development Program (grant No 2016YFC1300800), Beijing Scientific and Technologic (project grant No Z201100005520021), and Beijing Municipal Health Commission Continuing Education (project grant No BHTPP202018).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.