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Fusiform aneurysms of the vertebrobasilar arterial trunk: choice of endovascular methods and therapeutic efficacy

  • Clinical Article
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Abstract

Background

Fusiform aneurysms (FUANs) of vertebrobasilar arterial (VBA) trunk are difficult to treat by using current surgical and endovascular techniques. The objective of this study is to compare the efficacy of FUANs of VBA trunk which was treated with various therapeutic modalities including unilateral or bilateral vertebral artery occlusion, trapping of the aneurysm with coils, stent-assistant coiling, or sole stenting.

Methods

Between 2000 and 2008, 17 patients with FUANs (ranged in size from 8 to 45 mm) of VBA trunk in our hospital underwent endovascular treatment in our hospital. Eleven patients were evaluated by test occlusion with nondetachable silicone balloon or hyperglide balloon, and seven patients in this series passed testing with temporary balloon occlusion, among which four patients showed positive result, and three patients were conducted bilateral VA test occlusion. Finally, nine patients underwent a trapping of the aneurysm by coils, four patients were treated with stent-supported coil embolization, and four patients with nonhemorrhagic FUAN of VBA were treated only by stenting.

Results

The average imaging follow-up was 28 months, with a range from 6 to 48 months. Fourteen (82%) had excellent or good outcome, three (17.6%) had a poor outcome, and one (5.8%) died.

Conclusions

Management of FUANs of VBA trunk often poses difficult therapeutic problems. In some cases, multiple treatment sessions may be not only safe but also necessary for the effective treatment of these aneurysms to achieve a complete or an acceptable result.

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Abbreviations

AICA:

Anterior inferior cerebellar arteries

CT:

Computed tomography

CTA:

Computed tomographic angiography

DSA:

Digital subtraction angiography

FUAN:

Fusiform aneurysm

MRI:

Magnetic resonance image

PcoA:

Posterior communicating artery

VBA:

Vertebrobasilar arterial

VBJ:

Vertebrobasilar junction

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Authors and Affiliations

  1. Department of Neurosurgery, Huashan Hospital, Fudan University, No.12, Wulumuqi Mid Road, Shanghai, 200040, People’s Republic of China

    Qihong Wang, Bing Leng, Donglei Song & Gong Chen

  2. Neurosurgical Department, Shanghai Medical College, Fudan University, Shanghai, 200032, People’s Republic of China

    Qihong Wang, Bing Leng, Donglei Song & Gong Chen

Authors
  1. Qihong Wang
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  2. Bing Leng
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  3. Donglei Song
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  4. Gong Chen
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Corresponding author

Correspondence to Gong Chen.

Additional information

Contract grant sponsor is National Natural Science Foundation of China, and contract grant number is 30872676.

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Wang, Q., Leng, B., Song, D. et al. Fusiform aneurysms of the vertebrobasilar arterial trunk: choice of endovascular methods and therapeutic efficacy. Acta Neurochir 152, 1467–1476 (2010). https://doi.org/10.1007/s00701-010-0691-9

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  • DOI: https://doi.org/10.1007/s00701-010-0691-9

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