Аннотация:Background and aims: To study clinical and angiographicfollow up of dissecting aneurysms (DA) of internal carotid(ICA) and vertebral arteries (VA).Methods: We examined 289 patients with ICA/VAdissection verified by neuroimaging. Clinical follow-uplasted 5,7±3,8 years, during which 10 patients receivedanticoagulants, 18 – antiplatelet drugs. Eight patients werewithout antithrombotic drugs (AT), three patientssuccessfully underwent stenting. The last repeatedangiography was performed in 3,2±3,9 year.Results: DA was found in 36 patients (12%) (women, 58%,mean age -37,8±10,1 years): ICA – 21 patients, VA – 15.The DA size was less 10mm (19), more 10mm (17). Therewere no recurrent ischemic attacks during follow-up. Onrepeated angiography DA size was the same (13), increasedby 7,3±8,7mm (3) or decreased (1). 13 small DAdisappeared. The comparison of patients with and withoutDA showed that the former more often had multipledissections (38% vs 20%, p=0.022), whereas artery lumenocclusion in the acute period was less frequent (14% vs42%, p=0.001). The latter pointed to intramural hematoma(IMH) spreading to adventitia, rather than its subintimallocalization.Conclusion: The frequency of ICA/VA DA is 12%. Theirdevelopment is facilitated by a more pronounced the arterialwall weakness (multiple dissections, a tendency of IMHspreading to adventitia). DA, appears, to have a benigncourse and is not a source of embolism. It seems no clearindications for AT drugs to prevent ischemic recurrence.Indications for stenting are relative, given the favorableclinical course.Disclosure: Nothing to disclose