We can achieve a better outcome if size and volume of the aneurysm sac is smaller and if CPD is higher.

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Basilar Artery Occlusion (BAO) is a rare cause of stroke, occurring in about 1% of all the cases. BAO is characterized by bad prognosis and high death rate, which is about 75-91%. Neurological symptoms which accompany BAO are of large variety. BAO may occur suddenly, with or without previous prodromal symptoms or it may proceed progressively. Basilar artery occlusion always demands quick diagnosis and treatment. We are describing 5 cases of patients with basilar artery occlusion who were subjected to endovascular methods. The patients were treated with different intravascular techniques. Two patients had a stent Solitaire FR inserted, two others were applied targeted thrombolysis, one patient had combined therapy using targeted thrombolysis and mechanical thrombectomy-Penumbra device. Neurological symptoms were determined by using National Institutes of Health Stroke Scale (NIHSS). 60% of patients achieved the result, according to NIHSS, equal 0 or 1 point or improvement of ≥ 10 points, which is defined as neurological state changing for the better as well as the reduction of symptoms. Unblocking the basilar artery (TICI ≥ 2b) was successful with 80% of patients. The lack of disability was stated with 40% of the group under treatment (mRS ≤ 2). No patient had any complications connected with intravascular treatment. The treatment of basilar artery occlusion is difficult as nowadays there are no precise guidelines defining the most successful therapy. Our study shows that using intravascular methods is a good alternative for standard therapy of basilar artery occlusion, especially with those patients who cannot be qualified for intravenous thrombolysis due to overrunning the time window or with whom intravenous using of rt-PA was not efficient. The usage of endovascular methods is hoped to have great future prospects.

SummaryBackgroundHydrogel coils were created to improve the chances of an effective endovascular treatment of cerebral aneurysms. Achieving a high packing density of coils in the lumen of aneurysms can decrease the risk of recurrence. The aim of the present study is to report our initial experience on the effectiveness and safety of endovascular treatment of intracranial aneurysms with the use hydrogel coils.Material/MethodsSixty patients (age: 28–72 years) (45 women, 15 men) were treated. In 18 patients (30%), subarachnoid hemorrhage was present. Digital subtraction angiography (DSA) of cerebral vessels with rotational scanning was performed. Image analysis was performed by the Philips Integris 3D RA device,which is a specialized workstation (Three-Dimensional Rotational Angiography). 3D reconstructions of cerebral arteries were created based on the data. Sixty-six cerebral aneurysms were embolized with hydrogel coils, which expand in contact with blood. reaching the maximum diameter in about 20 minutes. In 29 aneurysms (43.9%), the effect of the procedure was confirmed on a follow-up DSA after 8.0±4.1 months from the initial treatment.ResultsA complete embolization was performed in 55 aneurysms (83.3%), and partial embolization in 11 aneurysms (16.7%). In 6 aneurysms (9.1%), re-embolization was necessary and it resulted in a complete embolization of 5 aneurysms. On a follow-up DSA, complete embolization was present in 25 aneurysms (86.2%), and partial embolization in 4 aneurysms (13.8%), respectively.ConclusionsEndovascular embolization with hydrogel coils is an effective and safe treatment method for cerebral aneurysms, although it carries the risk of some complications.