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Endovascular treatment of ruptured basilar artery trunk aneurysm in the acute period: risk factors for periprocedural complications

Authors
 Sook Young Sim  ;  Jai Ho Choi  ;  Myeong Jin Kim  ;  Yong Cheol Lim  ;  Joonho Chung 
Citation
 NEUROLOGICAL RESEARCH, Vol.45(2) : 152-159, 2023-02 
Journal Title
NEUROLOGICAL RESEARCH
ISSN
 0161-6412 
Issue Date
2023-02
MeSH
Aneurysm, Ruptured* / complications ; Basilar Artery / diagnostic imaging ; Basilar Artery / surgery ; Embolization, Therapeutic* ; Endovascular Procedures* / adverse effects ; Humans ; Intracranial Aneurysm* / complications ; Retrospective Studies ; Risk Factors ; Stents ; Thromboembolism* / complications ; Treatment Outcome
Keywords
Basilar artery ; basilar artery trunk ; endovascular treatment ; intracranial aneurysm ; stent
Abstract
Objectives: Endovascular treatment (EVT) has become a popular option for the treatment of basilar artery (BA) trunk aneurysms because microsurgery of these lesions is difficult due to narrow surgical fields and perforating arteries or cranial nerves in the brainstem. The purpose of this study is to report our experiences using EVT for ruptured BA trunk aneurysms in the acute period and to evaluate the risk factors for periprocedural complications.

Methods: From October 2004 to December 2020, a total of 27 consecutive patients with ruptured BA trunk aneurysms were treated with EVT. All patients met the following criteria: presence of ruptured BA trunk aneurysms and treatment with EVT for those aneurysms within 72 hours of rupture. The incidence of and risk factors for periprocedural complications were evaluated retrospectively.

Results: Among the 27 patients, periprocedural complications occurred in 4 patients (14.8%); mass effect inducing cranial neuropathy due to brainstem compression in 1 (3.7%) and brainstem infarction in 3 (11.1%). Hemorrhagic complications did not occur within 30 days. Subacute or delayed thromboembolic complications were not observed during the follow-up period. Large/giant aneurysm (odds ratio [OR], 6.417; 95% confidence interval [CI], 1.732-18.031; P = 0.045) and stent-assisted coiling (OR, 4.145; 95% CI, 1.018-14.212; P = 0.031) remained independent risk factors for periprocedural complications based on multiple logistic regression analysis.

Conclusions: When performing stent-assisted coiling for ruptured large/giant BA trunk aneurysms, awareness of and caution regarding periprocedural complications, such as brainstem infarction caused by thromboembolism or brainstem compression due to mass effect, are necessary.
Full Text
https://www.tandfonline.com/doi/full/10.1080/01616412.2022.2126680
DOI
10.1080/01616412.2022.2126680
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Chung, Joon Ho(정준호)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/193593
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