Cho Kwang-Chun, Jeon Pyoung, Kim Byung Moon, Lim Soo Mee, Jung Woo Sang, Kim Jung-Jae, Suh Sang Hyun
a Department of Neurosurgery , Catholic Kwandong University College of Medicine, International St. Mary's Hospital , Incheon , Korea.
b Department of Radiology , Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul , Korea.
Neurol Res. 2019 Jul;41(7):671-677. doi: 10.1080/01616412.2019.1611185. Epub 2019 May 2.
: Basilar artery trunk aneurysms (BTAs) are a rare pathology and difficult to treat. We present our experience regarding angiographic results and clinical outcomes for 16 BTAs treated by reconstructive endovascular treatment (EVT) using stent or balloon. : Between January 2003 and December 2014, 15 patients (mean age, 58.6 years; 11 males) with 16 BTAs were enrolled. Clinical manifestation, outcomes and procedural complications were evaluated retrospectively, and follow-up angiography was performed 12 and 24 months after procedure. : Subarachnoid hemorrhage (SAH) developed in seven aneurysms and nine were found incidentally. In one case, SAH followed by acute infarction on pons. The location of the aneurysms was the pure basilar artery (BA) trunk in 13 and the junction of the BA and the superior cerebellar artery in 3. Reconstructive EVT was technically successful in 15 aneurysms (93.8%) and failed in one due to the difficulty of vascular access. Stent/balloon-assisted coiling was performed in 13 aneurysms and sole stent therapy in two aneurysms. One patient had periprocedural complication of acute in-stent thrombosis. All treated patients had no symptoms with the usual activities except three patients, who died from myocardial infarction, aneurysmal rebleeding, and cerebellar infarction. Angiographic follow-up was performed in nine aneurysms; three aneurysms were recanalized (33.3%) and six aneurysms had no interval change (66.7%). There was no significant event during the follow-up period (mean, 23.5 months). : In the treatment of BTAs, reconstructive EVT may provide a feasible and safe option to microsurgery.
基底动脉主干动脉瘤（BTAs）是一种罕见的病变，治疗难度较大。我们介绍了使用支架或球囊进行重建性血管内治疗（EVT）的16例基底动脉主干动脉瘤的血管造影结果和临床结局。2003年1月至2014年12月，纳入了15例患有16个基底动脉主干动脉瘤的患者（平均年龄58.6岁；男性11例）。回顾性评估临床表现、结局和手术并发症，并在术后12个月和24个月进行随访血管造影。7例动脉瘤发生蛛网膜下腔出血（SAH），9例为偶然发现。1例患者SAH后出现脑桥急性梗死。动脉瘤位于单纯基底动脉（BA）主干的有13例，位于BA与小脑上动脉交界处的有3例。重建性血管内治疗在15例动脉瘤中技术成功（93.8%），1例因血管入路困难而失败。13例动脉瘤采用支架/球囊辅助弹簧圈栓塞，2例动脉瘤采用单纯支架治疗。1例患者出现急性支架内血栓形成的围手术期并发症。除3例死于心肌梗死、动脉瘤再出血和小脑梗死外，所有接受治疗的患者在日常活动中均无症状。对9例动脉瘤进行了血管造影随访；3例动脉瘤再通（33.3%），6例动脉瘤无间隔变化（66.7%）。随访期间（平均23.5个月）无重大事件发生。在基底动脉主干动脉瘤的治疗中，重建性血管内治疗可能为显微手术提供一种可行且安全的选择。
