Endovascular treatment of fusiform aneurisms of brain vessels

Abstract

Objective – to determine the effectiveness of endovascular treatment of fusiform arterial aneurysms of cerebral vessels.Materials and metods. The results of endovascular treatment of 25 patients with fusiform cerebral aneurysms who were treated at the Center in the period from 2011 to 2018 were analyzed. There were 12 men (48 %), women – 13 (52 %). The average age of patients is 48 years. In 17 (68 %) cases were vertebrobasilar aneurysms, in 2 (8 %) cases – aneurysms of the anterior cerebral artery, in 3 (12 %) cases – aneurysms of the middle cerebral artery, in 3 (12 %) cases – aneurysms of internal carotid arteries. For the treatment of patients we used various stents: flow diversion (FRED (Microvention, USA), Pipeline (ev3, USA)), Derivo (Acandis, Germany)) and protection stents (Leo (Balt, France), Solitaire (Medtronic, USA)), in deconstructive interventions – detachable coils.Results. It were performed 25 surgical interventions: in 23 (92 %) cases – reconstructive shutdown, in 2 (8 %) – deconstructive shutdown. There were no technical problems during surgical interventions. Complications were noted in two cases with VBB aneurysms in the early postoperative period stem disorders appeared due to the increasing mass effect. Both patients were dead. Control examination in a period from 6 months to 3 years 13 (52 %) patients were performed. The results of excluding aneurysms were evaluated on a Raymond–Roy scale. The type 1 was detected in 7 (53.8 %) patients, the type 2 – 1 (7.7 %), the type 3 – 5 (38.5 %). In 2 (15.4 %) patients bearing artery thrombosis was detected.Conclusions. Extrasacular endovascular methods of treating fusiform arterial aneurysms of cerebral vessels are effective and relatively safe. They can expand the indications for endovascular treatment of these aneurysms, however compared with the treatment of saccular aneurysms hemodynamic changes and secondary aneurysm thrombosis are unpredictable and require further study.