Endovascular reconstructive treatment of large and giant posterior circulation fusiform aneurysms

Abstract

Objective To explore the feasibility, safety and efficacy of endovascular reconstructive treatment of large and giant posterior circulation fusiform aneurysms. Methods A retrospective review was conducted on 22 cases of posterior circulation large and giant fusiform aneurysms who underwent endovascular reconstructive treatment between September 2007 and August 2017 at Neurosurgery Department of Beijing Hospital. Among the 22 cases, stent-assisted coiling was performed in 18 cases and sole stenting was applied in 4. Postoperative follow-up was conducted every 3-6 months at outpatient clinic or by phone. The modified Rankin scale (mRS) was used for outcome assessment. Imaging follow-up was conducted 3-24 months post operation. The outcomes was classified into stable, relieved and recurrent cases. Results Technical success rate was 100%. Peri-procedural complications occurred in 2 (9.1%) patients. One died from postoperative hemorrhagic complication and the other developed infarction and recovered well at discharge. A total of 21 patients were clinically followed-up for an average of 42.1±26.3 months (range: 4-105 months) and included 18 (85.7%) cases with good outcomes (mRS score: 0-2) and 3 (14.3%) with poor outcomes (mRS score: 4-6). Among 19 patients with angiographic follow-up of 11.9±6.9 months (range: 3-47 months), 10 patients achieved complete occlusion, 5 reported relief or stable conditions, 3 developed recurrence and 1 had in-stent occlusion. Conclusion Reconstructive endovascular treatment seems relatively safe for posterior circulation large and giant fusiform aneurysms with satisfactory mid-term results. Key words: Intracranial aneurysm; Embolization, therapeutic; Treatment outcome; Posterior circulation