ORIGINAL RESEARCH article
Front. Neurol.
Sec. Endovascular and Interventional Neurology
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1625207
Flow Diverter Implantation for CTA-Negative Giant Vertebral Artery Dissection Aneurysm: A Case Report
Provisionally accepted
- 1Department of Neurosurgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
- 2Neurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Objective: To evaluate the efficacy of flow diverter implantation for treating CTAnegative giant vertebral artery dissection aneurysm (VADA) and to address the challenges in lesion characterization using MRI.A 66-year-old male patient presented with a 3-month history of left facial numbness and dysarthria. Initial MRI-T1 revealed a mixed signal intensity lesion in the CPA region. However, both CTA and digital subtraction angiography (DSA) failed to identify any significant vascular abnormalities. Subsequently, CT-perfusion and dynamic contrast-enhanced computed tomography (DCE-CT) were performed to further characterize the lesion.Results: DCE-CT revealed a giant VADA, which was significantly larger than the lesion initially detected by MRI and was identified as the cause of hypoperfusion in the posterior circulation. Based on these findings, a flow diverter implantation procedure was performed successfully without complications. Angiographic follow-up at 8 months demonstrated no recurrence of the lesion. At the 14-month clinical follow-up, the patient exhibited complete resolution of symptoms, with a mRS score of 0, indicating an excellent functional outcome.Flow diverter implantation may be is an effective treatment for CTAnegative giant VADAs. The limitations of MRI in accurately characterizing lesion size underscore the necessity of advanced imaging techniques, such as DCE-CT, for precise device selection and deployment.
Keywords: Vertebral Artery, hypoperfusion, Vada, CTA, Flow diverter
Received: 16 Jun 2025; Accepted: 28 Aug 2025.
Copyright: © 2025 Li, Liu and Zhao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Kai-Jun Zhao, Department of Neurosurgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.