Clinical and radiographic characteristics of bilateral IVADAs with single-stage endovascular treatment
| Case no. | Presentation | Side, PICA-involving, ruptured | Configuration | H-H | Admission mRS score | Treatment | Immediate angiography* | Complication (days) | Follow-up angiography* (months) | Last mRS score (months) |
| 1 | Acute headache | R, involving, not determined L, involving, not determined | Pearl and string sign Fusiform | Ⅱ | 4 | SAC SAC | Near-complete obliteration Near-complete obliteration | – | Recanalisation (3)→recoiling→ stable (6) Complete obliteration (3) | 1 (6) |
| 2 | Headache | L, no involving, unruptured R, no involving, unruptured | Pearl and string sign Fusiform | – | 1 | SAC Trapping | Near-complete obliteration Complete obliteration | Muscle weakness of left limbs (3 days) | Complete obliteration (6) Complete obliteration (6) | 3 (48) |
| 3 | Dizziness | R, no involving, unruptured L, no involving, unruptured | Pearl and string sign Pearl and string sign | – | 1 | SAC SAC | Complete obliteration Complete obliteration | Sudden unconsciousness (2 months) | Complete obliteration (2) Complete obliteration (2) | 3 (36) |
| 4 | Incidence | R, no involving, unruptured L, no involving, unruptured | Pearl and string sign Fusiform | – | 0 | SAC Stent alone | Complete obliteration Partial obliteration | – | Complete obliteration (6) Complete obliteration (6) | 1 (30) |
*Angiography results are classified as follows: stable, no interval changes of the dissecting aneurysm in size or shape; complete obliteration, complete occlusion of the dissecting aneurysm sac with reconstruction of the parent artery; near-complete obliteration, neck remnant of the dissecting aneurysm.
H-H, Hunt-Hess; IVADAs, intracranial vertebral artery dissecting aneurysms; L, left; mRS, modified Rankin Scale; PICA, posterior inferior cerebellar artery; R, right; SAC, stent-assisted coiling.