Unfavorable Outcomes Related to Endovascular Treatment of Giant Vertebrobasilar Aneurysms

Frontiers in Neurology

Jie Wang¹  Miao Li²  Huaxin Liang² 

[1] Department of Neurology, The China-Japan Union Hospital of Jilin University, Changchun, China;Department of Neurosurgery, The China-Japan Union Hospital of Jilin University, Changchun, China;

关键词: giant vertebrobasilar aneurysms;    endovascular treatment;    outcome;    complications;    poor prognosis;   

DOI  :  10.3389/fneur.2020.00748

来源: DOAJ

【 摘 要 】

Background: Giant vertebrobasilar aneurysms (GVBAs) have an unfavorable natural history if left untreated and often pose a sizeable challenge to endovascular treatment. The aim of this study was to analyze the angiographic and clinical outcomes of GVBAs treated by various endovascular procedures.Methods: Between January 2010 and September 2018, 27 patients with 27 GVBAs treated endovascularly were enrolled in this consecutive study. The clinical and angiographic features, treatment modalities, and outcomes were analyzed.Results: The patient cohort comprised 21 men (77.8%) and 6 women (22.2%) of mean age 42.7 ± 18.9 years (range, 6–65 years). The most common presenting symptom was compressive symptoms, present in 15 patients (55.6%). None of the GVBAs was ruptured. Of the 27 GVBAs, 23 aneurysms were dissecting aneurysm with intramural hematoma and 4 aneurysms were saccular. Regarding treatment approach, internal trapping was used in 5 aneurysms, stent-assisted coil embolization in 10, sole stenting in 4, and flow diverters in 8. Overall, 12 patients (44.4%) had an unfavorable angiographic or clinical outcome: 3 patients presented with post-operative complications and subsequent death, and 9 with poor prognosis during follow-up.Conclusions: Patients with GVBAs may not benefit from endovascular treatment. Newer-generation devices are necessary to provide more optimal therapy for the management of these complex lesions.

【 授权许可】

Unknown