https://orcid.org/0000-0003-2745-446X
![Sample our Medicine, Dentistry, Nursing & Allied Health journals, sign in here to start your FREE access for 14 days]({"type":"image" , "src" : "/sda/5944/TOC-Subject-Sample-2021-Medicine-Dentistry-Nursing-Allied-Health.jpg"})
ABSTRACT
Objectives
Endovascular treatment (EVT) of basilar tip aneurysms (BTAs) is arduous because of the lesions’ angioarchitecture and the relatively high recanalization rate after EVT. In this study, we aimed to report the clinical characteristics of BTAs and evaluate the incidence of and risk factors for recanalization.
Methods
One hundred twenty-five patients with BTAs (11 ruptured, 114 unruptured) treated with EVT between 2009 and 2019 at one institution were retrospectively reviewed. Among them, 113 patients were included in statistical analyses. The anatomical parameters of the aneurysms and clinical data were analyzed. Univariate (chi-square test and t-test) and multivariate (multiple logistic regression) analyses were performed to identify risk factors for recanalization.
Results
Recanalization of the BTA occurred in 15 patients (13.3%). One patient (0.9%) was retreated endovascularly. The mean follow-up duration was 49.8 months. Neck size, posterior cerebral artery (PCA) angle, maximum diameter, and the rupture rate differed significantly between the recanalization and non-recanalization groups (P=.007, P<.001, P=.006, and P=.048, respectively). The maximum diameter (odds ratio, 1.483 per mm; 95% confidence interval, 1.145–1.919; P=.003) and PCA angle (odds ratio, 1.020 per degree; 95% confidence interval, 1.001–1.039; P=.036) were independently associated with recanalization.
Conclusions
Of all investigated BTAs, 96.8% were wide-neck aneurysms. The recanalization rate of BTAs after EVT was 13.3%. The PCA angle and maximal aneurysmal diameter were independently associated with recanalization; no associations were observed regarding vertebral artery dominance or modality of treatment. As such, BTA patients with wide PCA angles should be carefully monitored over time.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Ethical approval
All procedures performed in the studies involving human participants were in accordance with the ethical standards of our Institutional Review Board with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent
In this retrospective study, the requirement for informed consent was waived.
Additional information
Funding
Notes on contributors
Min Jeoung Kim
Min Jeoung Kim, M.D. is a fellow in the department of neurosurgery, Yonsei University College of Medicine. He has several publications in the application of neurosurgery.
Yong Bae Kim, M.D, Ph.D. is a neurosurgeon and majored in cerebrovascular disease. He is also undergoing microsurgery for cerebrovascular diseases. He is currently an professor at Yonsei University College of Medicine.
Keun Young Park
Keun Young Park, M.D., Ph.D. is a neurosurgeon and majored in cerebrovascular disease. He is also undergoing endovascular treatment as well as microsurgery for cerebrovascular diseases. He is currently an associate professor at Yonsei University College of Medicine.
Yong Bae Kim
Min Jeoung Kim, M.D. is a fellow in the department of neurosurgery, Yonsei University College of Medicine. He has several publications in the application of neurosurgery.
Yong Bae Kim, M.D, Ph.D. is a neurosurgeon and majored in cerebrovascular disease. He is also undergoing microsurgery for cerebrovascular diseases. He is currently an professor at Yonsei University College of Medicine.
Joonho Chung
Joonho Chung, M.D., Ph.D. is a neurosurgeon and majored in cerebrovascular disease. He is also undergoing endovascular treatment as well as microsurgery for cerebrovascular diseases. He is currently an associate professor at Yonsei University College of Medicine. He published many articles of various themes in the cerebrovascular field.