Endovascular treatment of posterior circulation aneurysms: Results from a single-team experience of 81 cases including 13 flow diversion treatment Tratamiento endovascular de aneurismas de circulación posterior: resultados de una experiencia de 81 casos realizada por un solo equipo, incluyendo 13 tratamientos de desviación de flujo


Dolas İ., Unal T. C., Gulsever C. İ., Sahin D., Huseynov H., BARBUROĞLU M., ...Daha Fazla

Neurocirugia, cilt.34, sa.4, ss.168-176, 2023 (SCI-Expanded) identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 34 Sayı: 4
  • Basım Tarihi: 2023
  • Doi Numarası: 10.1016/j.neucir.2022.05.002
  • Dergi Adı: Neurocirugia
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, DIALNET
  • Sayfa Sayıları: ss.168-176
  • Anahtar Kelimeler: Aneurysm, Endovascular, Posterior circulation, Stent, Subarachnoid hemorrhage
  • İstanbul Üniversitesi Adresli: Evet

Özet

© 2022Introduction: Relatively constant surgical risks and rapid advances in endovascular treatment have caused a major shift toward endovascular management of posterior circulation aneurysms. This paper presents the results of a series of endovascularly treated posterior circulation aneurysms. Methods: A total of 81 patients who underwent endovascular treatment of posterior circulation aneurysms performed by a single team between 2009 and 2019 were included. Demographic, clinical, radiologic, and management details were retrospectively obtained from hospital records. Results: Among the included patients, 50 (61.7%) and 31 (38.3%) were female and male, respectively. Subarachnoid hemorrhage was observed in 30 patients (37%). Moreover, 40 (49.3%) aneurysms were treated with stent-assisted coiling, 1 (1.2%) aneurysm was treated with parent artery occlusion, 2 (2.4%) aneurysms were coiled using balloon assistance, 24 (29.6%) aneurysms were coiled primarily, 1 (1.2%) patient had an unsuccessful treatment attempt, and 13 (16.0%) aneurysms were treated with flow-diverter stents or stent monotherapy. During the last follow-up, 57 (83.8%) aneurysms were completely occluded, whereas 6 (8.8%) and 2 (2.9%) aneurysms did and did not have a residual neck, respectively. Flow diversion was used to treat 13 patients, among whom 8 had total occlusion or stable residue. A total of 7 deaths (8.6%) were encountered in this series. Conclusion: Endovascular treatment should be considered as the primary treatment modality for posterior circulation aneurysms. Despite the high morbidity and mortality rates, promising results can be achieved with correct patient selection. Flow diversion can be a feasible alternative for complex aneurysms that are difficult to treat.