1140. Microsurgical Treatment for Complex Basilar Artery Aneurysms with Long-Term Follow-Up: a series of 40 cases
Authors: Xiang'en Shi (Beijing, China)
There has been a massive shift in the balance toward endovascular therapy for basilar artery (BA) aneurysms in the modern era.
We retrospectively reviewed clinical and radiologic data from patients with BA aneurysms who were treated in a single medical center from August 2006 to May 2018.
Forty consecutive patients with 46 aneurysms during the 12-year period were included. The rate of complete aneurysm occlusion in 40 cases using a 1-stage operation was 60.0% (23/39). The graft patency rates of 17 bypass surgeries were 88.2% (15/17) within 1 week and 76.5% (13/17) at 3 months after surgery. The mean 3-year outcome was favorable (modified Rankin Scale score 0-2) for 32 patients (80%) and poor (modified Rankin Scale score 3-5) for 5 patients (12.5%), and 3 patients died (7.5%). The survival for patients with BA apex aneurysms was higher than the survival observed for patients with BA trunk/vertebrobasilar junction aneurysms.
Microsurgical treatments for BA aneurysms can be effective, with good patient outcomes after operation. Patients with wide-necked, fusiform, or dolichoectatic aneurysms seem to exclude the aneurysm, preventing unnecessary retreatments with bypass techniques. The potential for a poor prognosis of patients with BA trunk/vertebrobasilar junction aneurysms was higher than that for patients with basilar apex aneurysms who presented with unfavorable subsequent events.