A giant fusiform basilar aneurysm treated by bilateral vertebral artery occlusion

Omahen, David A.; Findlay, J. Max

doi:10.1016/j.jocn.2003.06.002

Cited by 21 publications

(21 citation statements)

References 27 publications

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“…As the AICA-BA aneurysm points anteriorly in most cases, the neck is grasped by forceps and the sac is tipped away during the dissection, defining the pontine segment. 25,43,58,60 Spetzler used the subtemporal and subtemporal-transtentorial approach only once in the surgical treatment of 41 AICA aneurysms and cited a significant rate of morbidity associated with its use. 18 As a result, it is primarily used in the approach of midclival aneurysms.…”

Section: Management Options For Aica Aneurysmsmentioning

confidence: 99%

Management of anterior inferior cerebellar artery aneurysms: an illustrative case and review of literature

Bambakidis

Manjila

Dashti

et al. 2009

FOC

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Aneurysms of the anterior inferior cerebellar artery (AICA) are relatively rare among intracranial aneurysms. They can occur in 1 of 3 regions of the AICA: 1) craniocaudal (high or low riding), 2) mediolateral-premeatal (proximal), and 3) meatal-postmeatal (distal). The management strategies for treatment differ according to the location and configuration of the aneurysm. The existing body of neurosurgical literature contains articles published on aneurysms arising from the AICA near the basilar artery (BA), intracanalicular/meatal aneurysms, and distal AICA. Several therapeutic options exist, encompassing microsurgical and endovascular techniques. The authors describe a case of treatment involving a large BA-AICA aneurysm approached via exposure of the presigmoid dura using a retromastoid suboccipital craniectomy and partial petrosectomy. Treatment of these lesions requires detailed knowledge of the anatomy, and an anatomical overview of the AICA with its arterial loops and significant branches is presented, including a discussion of the internal auditory (labyrinthine) artery, recurrent perforating arteries, subarcuate artery, and cerebellosubarcuate artery. The authors discuss the various surgical approaches (retromastoid, far lateral, subtemporal, and transclival) with appropriate illustrations, citing the advantages and disadvantages in accessing these AICA lesions in relation to these approaches. The complications of these different surgical techniques and possible clinical effects of parent artery occlusion during AICA surgery are highlighted.

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Section: Management Options For Aica Aneurysmsmentioning

confidence: 99%

Management of anterior inferior cerebellar artery aneurysms: an illustrative case and review of literature

Bambakidis

Manjila

Dashti

et al. 2009

FOC

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“…Various endovascular treatment strategies have been reported in treating giant vertebrobasilar aneurysms, including proximal occlusion of the parent artery, internal trapping, and stent techniques. Traditionally, parent artery occlusion (PAO) was thought to be the most effective technique in cases of unclippable giant aneurysms [3,4,13,14]. Lubicz et al [3] reported long-term follow-up of 13 patients with a giant vertebrobasilar aneurysm treated by aneurysm trapping and PAO after BOT.…”

Section: Discussionmentioning

confidence: 99%

Endovascular treatment for large and giant fusiform aneurysms of the vertebrobasilar arteries

Chen

Yang²,

Miao

et al. 2013

Clinical Imaging

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“…Several neurosurgical approaches have been used to access the BA as described by many authors, but these approaches have been successful only in the hands of a limited number of skilled neurosurgeons 4,13,[17][18][19]21,23,27 . On the other hand, endovascular access to the BA is not difficult in general [10][11][12]19,22,24,30 . Endovascular neurosurgery has offered a striking therapeutic benefit because endovascular access is not affected by complex arteries of the BA trunk such as 3.8% in other series of posterior circulation (9,26).…”

Section: Discussionmentioning

confidence: 99%

“…As in other reported series, thromboembolic events seem to be the most common complication, and special attention must be paid to platelet aggregation in cases treated with stent placement 1,6,25,29 . Although detachable coils have provided an alternative approach to treatment, they have their own difficulties in the treatment of giant and fusiform aneurysms of the BA 5,11,24,30,31 . Clot formation in the sac does not mean the aneurysm is completely cured, particularly with giant aneurysms or aneurysms with a wide neck in which the main blood stream impinges upon the orifice of the aneurysm and may disturb endothelialization of the aneurysm orifice 12 .…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcomes of Basilar Artery Aneurysms

2009

Neuroradiol J

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To evaluate the effects of endovascular treatments, we retrospectively analyzed a consecutive series of patients with basilar artery aneurysms (BAAs) treated endovascularly. During a seven year period, 43 patients (mean age 42.2 years, male/female ratio 21:22) with BAAs were treated mainly with endovascular techniques at Beijing Tiantan Hospital. Pretreatment clinical grades were determined using the Hunt-Hess scale. Outcome was evaluated using the Glasgow Outcome Scale scores (GOS) during a mean follow-up period of 21.1 months (range, 1 to 72 months). Forty-three patients had 44 BAAs, one MCA aneurysm and one P1 aneurysm. Endovascular treatment was technically feasible in 40 patients. One aneurysm thrombosed spontaneously after initial angiography. Four (9.3%) patients died periprocedurally. Immediate postprocedural angiograms in 44 BAAs showed that complete occlusion was achieved in 33 BAAs, subtotal occlusion in one and incomplete occlusion in seven. Follow-up angiographic results in 30 patients confirmed complete occlusion of 27 aneurysms, subtotal occlusion in one, and incomplete occlusion in two. Two patients with vertebrobasilar atheromatous fusiform aneurysms were treated with antiplatelet medications. Long-term outcome was good (GOS Score 4 or 5) in 39 patients (90.7%) and fatal (GOS Score 1) in four (9.3%). Favorable overall long-term outcome can be achieved in patients with BA apex aneurysms, and in 78.6% of those with BA trunk aneurysms when using endovascular techniques. Endovascular coil embolization of BAAs is an effective treatment in the long-term. Patients with vertebrobasilar atheromatous fusiform aneurysms can be treated with antiplatelet medications.

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A giant fusiform basilar aneurysm treated by bilateral vertebral artery occlusion

Cited by 21 publications

References 27 publications

Management of anterior inferior cerebellar artery aneurysms: an illustrative case and review of literature

Management of anterior inferior cerebellar artery aneurysms: an illustrative case and review of literature

Endovascular treatment for large and giant fusiform aneurysms of the vertebrobasilar arteries

Clinical Outcomes of Basilar Artery Aneurysms

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