Unfavorable Outcomes Related to Endovascular Treatment of Giant Vertebrobasilar Aneurysms
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.Met...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-08-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fneur.2020.00748/full |
| _version_ | 1818495533646348288 |
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| author | Miao Li Huaxin Liang Jie Wang |
| author_facet | Miao Li Huaxin Liang Jie Wang |
| author_sort | Miao Li |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-10T18:21:46Z |
| format | Article |
| id | doaj.art-b41853ba92454975955e82d369e49b97 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-10T18:21:46Z |
| publishDate | 2020-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-b41853ba92454975955e82d369e49b972022-12-22T01:38:11ZengFrontiers Media S.A.Frontiers in Neurology1664-22952020-08-011110.3389/fneur.2020.00748484761Unfavorable Outcomes Related to Endovascular Treatment of Giant Vertebrobasilar AneurysmsMiao Li0Huaxin Liang1Jie Wang2Department of Neurosurgery, The China-Japan Union Hospital of Jilin University, Changchun, ChinaDepartment of Neurosurgery, The China-Japan Union Hospital of Jilin University, Changchun, ChinaDepartment of Neurology, The China-Japan Union Hospital of Jilin University, Changchun, ChinaBackground: 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.https://www.frontiersin.org/article/10.3389/fneur.2020.00748/fullgiant vertebrobasilar aneurysmsendovascular treatmentoutcomecomplicationspoor prognosis |
| spellingShingle | Miao Li Huaxin Liang Jie Wang Unfavorable Outcomes Related to Endovascular Treatment of Giant Vertebrobasilar Aneurysms Frontiers in Neurology giant vertebrobasilar aneurysms endovascular treatment outcome complications poor prognosis |
| title | Unfavorable Outcomes Related to Endovascular Treatment of Giant Vertebrobasilar Aneurysms |
| title_full | Unfavorable Outcomes Related to Endovascular Treatment of Giant Vertebrobasilar Aneurysms |
| title_fullStr | Unfavorable Outcomes Related to Endovascular Treatment of Giant Vertebrobasilar Aneurysms |
| title_full_unstemmed | Unfavorable Outcomes Related to Endovascular Treatment of Giant Vertebrobasilar Aneurysms |
| title_short | Unfavorable Outcomes Related to Endovascular Treatment of Giant Vertebrobasilar Aneurysms |
| title_sort | unfavorable outcomes related to endovascular treatment of giant vertebrobasilar aneurysms |
| topic | giant vertebrobasilar aneurysms endovascular treatment outcome complications poor prognosis |
| url | https://www.frontiersin.org/article/10.3389/fneur.2020.00748/full |
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