Microsurgical Treatment for Complex Basilar Artery Aneurysms With Long-Term Follow-Up in A Series of 35 Cases.

Microsurgical Treatment for Complex Basilar Artery Aneurysms With Long-Term Follow-Up in A Series of 35 Cases.

World Neurosurg. 2018 Jan 06;:

Authors: Liu Y, Shi X, K C KIS, Sun Y, Liu F, Qian H, Zhang J

Abstract
BACKGROUND: There has been a massive shift in the balance toward endovascular therapy for basilar artery (BA) aneurysms in the modern era.
METHODS: The authors retrospectively reviewed clinical and radiological data from patients with BA aneurysms who were treated in a single medical center during a 10-year period from August 2006 to May 2016.
RESULTS: Thirty-five consecutive patients with 46 aneurysms during the 10-year period were included. The rate of complete aneurysm occlusion in 35 cases using a one-stage operation was 58.8% (20/34). The graft patency rates of 13 bypass surgeries were 84.6% (11/13) within one week and 69.2% (9/13) at three months after surgery. The cut flow index (CFI) for all bypass cases was 0.79. The overall survival rate was 94% at discharge (2 patients died). The three-month outcome was favorable (modified Rankin Scale (mRS) score: 0-2) for 27 (77.1%) patients, poor (mRS score: 3-5) for 5(14.2%) patients and 3 (8.6%) patients died. The survival rate for patients with BA apex aneurysms was higher than that the survival rate observed for patients with BA trunk/ vertebrobasilar (VB) junction aneurysms.
CONCLUSIONS: Microsurgical treatments for BA aneurysms can be effective, with good patient outcomes in the early stage after operation. Patients with wide-necked, fusiform, or dolichoectatic aneurysms appear to exclude the aneurysm, preventing unnecessary retreatments with bypass techniques. The potential for a poor prognosis of patients with BA trunk/VB junction aneurysms was somewhat higher than that for patients with basilar apex aneurysms who presented with unfavorable subsequent events.

PMID: 29317359 [PubMed - as supplied by publisher]

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