Stenting of vertebral artery dissecting aneurysms (VADAs) may promote mural apposition of intimal flaps, preserving the patency of injured vessels. Moreover, stent deployment may serve to alter intra-aneurysm flow, inducing saccular thrombus formation, neointimal development, and remodeling of injured vessels. Although an overlapping multistent strategy with coiling has proven successful in this setting, yielding good anatomic and clinical outcomes, coiling may be technically infeasible in some VADAs with unfavorably configured circumferential elevations. Herein, we describe three patients with VADAs for whom coiling was deemed technically problematic. Each underwent double stenting (LVIS within Enterprise), without coil insertion, using local anesthesia. Conventional angiographic follow-up regularly disclosed excellent saccular occlusion and subsequent remodeling of stented arteries. LVIS-within-Enterprise double stenting may be of particular benefit in patients with VADAs, the Enterprise providing outer support to minimize stent bulging (as a fusiform aneurysm) as the inner LVIS reinforces flow diversion.

椎动脉夹层动脉瘤（VADA）的支架植入可以促进内膜瓣的壁贴合，从而保持受损血管的通畅。此外，支架部署可能有助于改变动脉瘤内血流，诱导囊状血栓形成、新内膜发育和受损血管重塑。尽管带盘绕的重叠多支架策略在这种情况下已被证明是成功的，产生了良好的解剖和临床结果，但在一些圆周高度配置不利的 VADA 中，盘绕在技术上可能不可行。在此，我们描述了三名 VADA 患者，他们的弹簧圈被认为在技术上存在问题。每例均接受双支架置入术（Enterprise 内的 LVIS），无需插入线圈，使用局部麻醉。传统的血管造影随访定期显示出良好的囊状闭塞和随后的支架动脉重塑。LVIS-in-Enterprise 双支架置入术可能对 VADA 患者特别有益，Enterprise 提供外部支撑以最大程度地减少支架膨胀（如梭形动脉瘤），因为内部 LVIS 增强血流分流。