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Endovascular treatment for large (> 10 mm) basilar tip aneurysms: a retrospective case series

 Min Jeoung Kim  ;  Joonho Chung  ;  Keun Young Park  ;  Yong Bae Kim  ;  Dong Joon Kim  ;  Byung Moon Kim  ;  Jae Whan Lee 
 ACTA NEUROCHIRURGICA, Vol.164(5) : 1239-1245, 2022-05 
Journal Title
Issue Date
Cerebral Angiography / methods ; Embolization, Therapeutic* / methods ; Endovascular Procedures* / methods ; Follow-Up Studies ; Humans ; Intracranial Aneurysm* / diagnostic imaging ; Intracranial Aneurysm* / surgery ; Middle Aged ; Retrospective Studies ; Treatment Outcome
Basilar tip aneurysms ; Endovascular treatment ; Large aneurysm
Purpose: To report the long-term clinical and angiographic outcomes of the endovascular treatment of large/giant basilar tip aneurysms (BTAs) in our institutions.

Methods: We retrospectively reviewed cases of BTA larger than 10 mm that received endovascular treatment between January 2009 and December 2019. Data on the demographic and clinical characteristics and radiologic severity were obtained from the patients' medical records. The collected clinical follow-up data included neurological evaluation. Magnetic resonance angiography (MRA) was performed 6 to 12 months after the procedure, followed by once every 1 to 2 years as needed.

Results: A total of 12 patients with BTA were included in this study. The median age was 60.08 years (27-80 years), and the mean clinical follow-up was 66.78 months (19.00-142.87 months). Almost half of the patients presented with unruptured BTAs (58.33%, n = 7). The median maximum aneurysm diameter was 13.00 mm (10.46-20.90 mm) and the mean neck size was 8.34 mm (4.82-13.04 mm). A Modified Raymond Roy Classification (MRRC1) of 1 or 2 was observed in 66.67% of the patients (n = 8) immediately after the first procedure. Procedural morbidity and mortality were 33.33% and 8.33%, respectively. Major recanalization occurred in two patients, one of whom underwent additional coiling with the other being merely observed due to older age.

Conclusion: It is very difficult to cure a large BTA completely at once and recanalization occurred often after endovascular treatment. Conducting long-term follow-up studies at short intervals is warranted, as well as improving existing treatment methods and developing new approaches.
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1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Joon(김동준) ORCID logo https://orcid.org/0000-0002-7035-087X
Kim, Min Jeoung(김민정)
Kim, Byung Moon(김병문) ORCID logo https://orcid.org/0000-0001-8593-6841
Kim, Yong Bae(김용배) ORCID logo https://orcid.org/0000-0003-2262-7157
Park, Keun Young(박근영)
Lee, Jae Whan(이재환)
Chung, Joon Ho(정준호)
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