Enlargement of Asymptomatic VA Dissecting Aneurysm after Initial Treatment with Stent-assisted Coil Embolization with Contra Lateral Ruptured VA Dissecting Aneurysm Treated by Parent Artery Occlusion: A Case Report

Objective: A rare case of enlargement of asymptomatic dissecting aneurysm after its initial treatment with stent-assisted coiling with parent artery occlusion for the ruptured contra lateral side is reported. Case Presentation: A 52-year-old male patient presented with a subarachnoid hemorrhage resulting from a bilateral vertebral artery dissecting aneurysms. The patient was treated within 24 hours of the hemorrhage to prevent re-rupture by parent artery occlusion of the right vertebral artery and stent-assisted coiling of the left side. A 6-month follow-up showed an enlargement of the left side dissecting aneurysm. A second treatment was done to the left side also using stent-assisted coiling. The patient was discharged with no neurological deficit. Conclusion: To our knowledge, parent artery occlusion for ruptured vertebral artery dissecting aneurysms (VADA) may cause contra lateral VADA enlargement even after its initial treatment by stent-assisted coil embolization in the same setting.