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  • Title: Microsurgical Treatment for Complex Basilar Artery Aneurysms with Long-Term Follow-Up in a Series of 35 Cases.
    Author: Liu Y, Shi X, Kc KIS, Sun Y, Liu F, Qian H, Zhang J.
    Journal: World Neurosurg; 2018 Mar; 111():e710-e721. PubMed ID: 29317359.
    Abstract:
    BACKGROUND: There has been a massive shift in the balance toward endovascular therapy for basilar artery (BA) aneurysms in the modern era. METHODS: We retrospectively reviewed clinical and radiologic data from patients with BA aneurysms who were treated in a single medical center during a 10-year period from August 2006 to May 2016. RESULTS: Thirty-five consecutive patients with 46 aneurysms during the 10-year period were included. The rate of complete aneurysm occlusion in 35 cases using a 1-stage operation was 58.8% (20/34). The graft patency rates of 13 bypass surgeries were 84.6% (11/13) within 1 week and 69.2% (9/13) at 3 months after surgery. The cut flow index for all bypass cases was 0.79. The overall survival was 94% at discharge (2 patients died). The 3-month outcome was favorable (modified Rankin Scale score 0-2) for 27 patients (77.1%) and poor (modified Rankin Scale score 3-5) for 5 patients (14.2%), and 3 patients died (8.6%). The survival for patients with BA apex aneurysms was higher than the survival observed for patients with BA trunk/vertebrobasilar junction aneurysms. CONCLUSIONS: Microsurgical treatments for BA aneurysms can be effective, with good patient outcomes in the early stage 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.
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