To evaluate the efficacy of endovascular treatment of vertebrobasilar dissecting aneurysm (VBDA).

Thirty-seven patients with dissecting aneurysms in the vertebrobasilar artery admitted to Zhongshan Hospital Affiliated to Xiamen University from April 2014 to April 2018 were analyzed retrospectively. The demographic data, the characteristics of aneurysms, and the incidence of perioperative complications in the patients were collected. The clinical prognosis of the patients at discharge and 6 months of follow-up were recorded, and the modified Rankin scale (mRS) was used to evaluate the postoperative outcomes.

Among the 37 patients, there were 24 men and 13 women with a mean age of 54 years (range 24-78 years). Endovascular treatments were applied in a total of 29 patients, and the other 8 refused surgery. The study included 32 VBDA, of which 25 were treated with stent-coil embolization, 3 with pure coil embolization, and 4 with permanent occlusion of vertebral artery dissecting aneurysms and/or vertebral artery. All patients underwent early endovascular treatment (＜72 h). During the postoperative follow-up, 4 cases recurred and underwent interventional treatment again, and the rest remained stable. In the follow-up of the vertebral artery and the basilar artery dissecting aneurysm, the prognosis was excellent in 13 cases and 7 cases; good in 3 cases and 2 cases; poor in 1 case and 3 cases; and no cases of deaths have been reported, respectively; and the lower the Hunt-Hess grade at admission for vertebral artery dissection aneurysm, the better the prognosis (H=7.566, P=0.006), and the lower the Hunt-Hess grade and the World Federation of Neurosurgical Societies (WFNS）grade at admission for basilar artery dissection aneurysm, the better the prognosis (H=5.666, P=0.017). In addition, the proportion of VBDA patients with Hunt-Hess grade 0 -Ⅲ at admission was a better outcome than that in the Ⅳ-Ⅴ group,with 90.0% vs 22.2%, P=0.001, respectively.

Endovascular interventional procedures of vertebrobasilar dissecting aneurysms are applicable to most patients. They can prevent rebleeding safely and effectively without significant complications, showing a good follow-up outcome. Low preoperative Hunt-Hess grade can predict favorable clinical outcomes. In addition, early embolization can not affect clinical outcomes, but reduce the risk of rebleeding.