https://orcid.org/0000-0003-2745-446X
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ABSTRACT
Objectives
Endovascular treatment (EVT) has become a popular option for the treatment of basilar artery (BA) trunk aneurysms because microsurgery of these lesions is difficult due to narrow surgical fields and perforating arteries or cranial nerves in the brainstem. The purpose of this study is to report our experiences using EVT for ruptured BA trunk aneurysms in the acute period and to evaluate the risk factors for periprocedural complications.
Methods
From October 2004 to December 2020, a total of 27 consecutive patients with ruptured BA trunk aneurysms were treated with EVT. All patients met the following criteria: presence of ruptured BA trunk aneurysms and treatment with EVT for those aneurysms within 72 hours of rupture. The incidence of and risk factors for periprocedural complications were evaluated retrospectively.
Results
Among the 27 patients, periprocedural complications occurred in 4 patients (14.8%); mass effect inducing cranial neuropathy due to brainstem compression in 1 (3.7%) and brainstem infarction in 3 (11.1%). Hemorrhagic complications did not occur within 30 days. Subacute or delayed thromboembolic complications were not observed during the follow-up period. Large/giant aneurysm (odds ratio [OR], 6.417; 95% confidence interval [CI], 1.732–18.031; P = 0.045) and stent-assisted coiling (OR, 4.145; 95% CI, 1.018–14.212; P = 0.031) remained independent risk factors for periprocedural complications based on multiple logistic regression analysis.
Conclusions
When performing stent-assisted coiling for ruptured large/giant BA trunk aneurysms, awareness of and caution regarding periprocedural complications, such as brainstem infarction caused by thromboembolism or brainstem compression due to mass effect, are necessary.
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.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Additional information
Funding
Notes on contributors
Sook Young Sim
Sook Young Sim, M.D., Ph.D. is a neurosurgeon and majored in cerebrovascular disease. She is also undergoing endovascular treatment as well as microsurgery for cerebrovascular diseases. She is currently an associate professor at Inje University Ilsan Paik Hospital.
Jai Ho Choi
Jai Ho Choi, 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 Seoul St. Mary’s Hospital, The Catholic University of Korea.
Myeong Jin Kim
Myeong Jin Kim, 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 Gachon University Gil Medical Center.
Yong Cheol Lim
Yong Cheol Lim, 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 a professor and the chairmen of Department of Neurosurgery, Ajou University Hospital.
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.