Identifying Recurrence Risk Factors in Vertebral Artery Dissecting Aneurysms Post-Intervention

Background In the realm of neurovascular disorders, vertebral artery dissecting aneurysms (VADA) stand out due to their significant morbidity and mortality rates, particularly when they lead to subarachnoid hemorrhage (SAH). Despite advancements in interventional therapies, the recurrence of VADA post-treatment remains a critical challenge, with a reported recurrence rate of 13%-25.7%. This study aims to bridge the gap in understanding the risk factors contributing to VADA recurrence after interventional therapy, a domain that has seen limited exploration. Method Employing a retrospective analysis, we reviewed the medical records of 64 patients diagnosed with VADA and treated with interventional therapy from 2015 to 2024. Patients were categorized based on the presence of SAH, the relationship of VADA to the posterior inferior cerebellar artery (PICA), and the type of interventional therapy received. Statistical analyses, including univariate and multivariate logistic regression, were utilized to identify factors associated with VADA recurrence. Result Our findings reveal that VADA located on the dominant side and the length of the dissection in the artery significantly increased the risk of recurrence. Moreover, the type of interventional therapy, specifically the use of engraving laser stent-assisted coil (SAC-L), was associated with higher recurrence rates compared to other methods. The complete occlusion rate was notably higher in patients treated with regular braided stent-assisted coil (SAC-B) and parent artery occlusion (PAO). Conclusion This study underscores the importance of considering the anatomical location of VADA and the choice of interventional therapy in mitigating the risk of recurrence. Our analysis provides critical insights into the factors influencing VADA recurrence, offering a valuable resource for clinicians in tailoring treatment strategies to improve patient outcomes.