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Operative and Endovascular Management of Extracranial Vertebral Artery Aneurysm in Ehlers-Danlos Syndrome: A Clinical Dilemma

Case Report and Literature Review

Department of Vascular and Endovascular Surgery, St James's Vascular Institute, St James's Hospital, Trinity College, Dublin, Ireland sherifsultan{at}esatclear.ie

Mark Morasch, MD, FACS

Northwestern University, Chicago, IL

Mary-Paula Colgan, MD

Prakash Madhavan, MD, FRCS

Dermot Moore, MD, FRCS

Gregor Shanik, MD, FRCS

St James's Vascular Institute, St James's Hospital, Trinity College, Dublin, Ireland

The most prevalent lesion of the vertebral artery is an atheromatous plaque located at its origin from the subclavian artery. A case of successful management of a symptomatic vertebral artery aneurysm due to Ehlers-Danlos syndrome is reported. The patient had asymptomatic posterior intracerebral artery dissection on the contralateral side. A common carotid artery to V-3 segment bypass using reversed saphenous vein graft was carried out. Avulsion of the V-2 segment occurred peroperatively and endovascular coil embolization of the vertebral artery aneurysm was performed. Endovascular equipment and training must be in the armamentarium of vascular surgeons as more complex cases are being treated, which demands new approaches for ultimate clinical success. This unique case outlines what might unexpectedly occur. Endovascular intervention as an adjuvant procedure provides a satisfactory outcome in what could have been a catastrophe.

Vascular and Endovascular Surgery, Vol. 36, No. 5, 389-392 (2002)
DOI: 10.1177/153857440203600510


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