Treatment Results for Basilar Artery Aneurysms

Seung, Won Bae

Abstract

OBJECTIVES
We report our recent treatment results of ruptured and unruptured basilar artery aneurysms during the last 2 years.
METHODS
A retrospective analysis was performed on 21 patients with basilar artery aneurysms managed with endovascular and microsurgical treatments from January 2007 to December 2008. Successful embolization was defined as more than 90% occlusion. Clinical outcome was evaluated using the Glasgow Outcome Scale (GOS) at 6 months, and follow-up angiography was obtained at 6 to 12 months.
RESULTS
Based on the Hunt and Hess grading scale, the patient population included 8 patients (38.1%) with unruptured aneurysms, 3 patients with grade II, 6 with grade III, 2 with grade IV, and 2 with grade V. Microsurgical clipping was done in 3 patients with ruptured aneurysms, and the other patients were treated by the endovascular method. Clinical outcome was revealed 5 patients (38.5%) with GOS 5, 1 (7.7%) with GOS 4, 3 (23.1%) with GOS 3, and 2 patients (15.4%) died. Of all the patients that underwent endovascular treatment, 10 patients (55.6%) had successful embolization. On angiographic follow-up, recanalizations developed in 3 patients (17.6%) and these patients were treated by repeat embolizations.
CONCLUSIONS
Endovascular coil embolization is a safe and effective method in basilar artery aneurysms although occasionally require repeat embolizations. Surgical treatment was indicated in restricted number of ruptured cases.