1
|
Dolas I, Unal TC, Gulsever CI, Sahin D, Huseynov H, Barburoglu M, Ozturk O, Can H, Adiyaman AE, Dagdeviren HE, Sabanci PA, Aydoseli A, Aras Y, Sencer A, Sencer S. Endovascular treatment of posterior circulation aneurysms: Results from a single-team experience of 81 cases including 13 flow diversion treatment. Neurocirugia (Astur : Engl Ed) 2023:S2529-8496(22)00097-1. [PMID: 36774258 DOI: 10.1016/j.neucie.2022.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 05/29/2022] [Indexed: 02/11/2023]
Abstract
INTRODUCTION Relatively constant surgical risks and rapid advances in endovascular treatment have caused a major shift toward endovascular management of posterior circulation aneurysms. This paper presents the results of a series of endovascularly treated posterior circulation aneurysms. METHODS A total of 81 patients who underwent endovascular treatment of posterior circulation aneurysms performed by a single team between 2009 and 2019 were included. Demographic, clinical, radiologic, and management details were retrospectively obtained from hospital records. RESULTS Among the included patients, 50 (61.7%) and 31 (38.3%) were female and male, respectively. Subarachnoid hemorrhage was observed in 30 patients (37%). Moreover, 40 (49.3%) aneurysms were treated with stent-assisted coiling, 1 (1.2%) aneurysm was treated with parent artery occlusion, 2 (2.4%) aneurysms were coiled using balloon assistance, 24 (29.6%) aneurysms were coiled primarily, 1 (1.2%) patient had an unsuccessful treatment attempt, and 13 (16.0%) aneurysms were treated with flow-diverter stents or stent monotherapy. During the last follow-up, 57 (83.8%) aneurysms were completely occluded, whereas 6 (8.8%) and 2 (2.9%) aneurysms did and did not have a residual neck, respectively. Flow diversion was used to treat 13 patients, among whom 8 had total occlusion or stable residue. A total of 7 deaths (8.6%) were encountered in this series. CONCLUSION Endovascular treatment should be considered as the primary treatment modality for posterior circulation aneurysms. Despite the high morbidity and mortality rates, promising results can be achieved with correct patient selection. Flow diversion can be a feasible alternative for complex aneurysms that are difficult to treat.
Collapse
Affiliation(s)
- Ilyas Dolas
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Tugrul Cem Unal
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Cafer Ikbal Gulsever
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey.
| | - Duran Sahin
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Heydar Huseynov
- Department of Radiology, Istanbul Atlas University, Istanbul, Turkey
| | - Mehmet Barburoglu
- Department of Radiology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Onur Ozturk
- Department of Neurosurgery, Istanbul Bilim University, Istanbul, Turkey
| | - Halil Can
- Department of Neurosurgery, Istanbul Atlas University, Istanbul, Turkey
| | - Ali Ekrem Adiyaman
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Huseyin Emre Dagdeviren
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Pulat Akin Sabanci
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Aydin Aydoseli
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Yavuz Aras
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Altay Sencer
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Serra Sencer
- Department of Radiology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| |
Collapse
|