Endovascular embolization versus surgical clipping in a single surgeon series of basilar artery aneurysms: a complementary approach in the endovascular era
| العنوان: | Endovascular embolization versus surgical clipping in a single surgeon series of basilar artery aneurysms: a complementary approach in the endovascular era |
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| المؤلفون: | Ethan A. Winkler, Roberto Rodriguez Rubio, Mitchel S. Berger, Anthony T. Lee, S. Andrew Josephson, Kunal P. Raygor, John K. Yue, Adib A. Abla, Daniel M.S. Raper, W. Caleb Rutledge |
| المصدر: | Acta Neurochirurgica Acta neurochirurgica, vol 163, iss 5 |
| بيانات النشر: | Springer Vienna, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Adult, Male, medicine.medical_specialty, Original Article - Vascular Neurosurgery - Aneurysm, Microsurgery, medicine.medical_treatment, Clinical Sciences, Outcomes, Aneurysm, Postoperative Complications, medicine.artery, medicine, Basilar artery, Humans, Endovascular coil embolization, Embolization, cardiovascular diseases, Neuroradiology, Aged, Neurology & Neurosurgery, medicine.diagnostic_test, business.industry, Microsurgical clipping, Endovascular Procedures, Neurosciences, Interventional radiology, Intracranial Aneurysm, Middle Aged, medicine.disease, Surgical Instruments, Embolization, Therapeutic, Surgery, Basilar Artery, Cohort, cardiovascular system, Stents, Neurology (clinical), Neurosurgery, business |
| الوصف: | Background Currently, most basilar artery aneurysms (BAAs) are treated endovascularly. Surgery remains an appropriate therapy for a subset of all intracranial aneurysms. Whether open microsurgery would be required or utilized, and to what extent, for BAAs treated by a surgeon who performs both endovascular and open procedures has not been reported. Methods Retrospective analysis of prospectively maintained, single-surgeon series of BAAs treated with endovascular or open surgery from the first 5 years of practice. Results Forty-two procedures were performed in 34 patients to treat BAAs—including aneurysms arising from basilar artery apex, trunk, and perforators. Unruptured BAAs accounted for 35/42 cases (83.3%), and the mean aneurysm diameter was 8.4 ± 5.4 mm. Endovascular coiling—including stent-assisted coiling—accounted for 26/42 (61.9%) treatments and led to complete obliteration in 76.9% of cases. Four patients in the endovascular cohort required re-treatment. Surgical clip reconstruction accounted for 16/42 (38.1%) treatments and led to complete obliteration in 88.5% of cases. Good neurologic outcome (mRS ≤ 2) was achieved in 88.5% and 75.0% of patients in endovascular and open surgical cohorts, respectively (p = 0.40). Univariate logistic regression analysis demonstrated that advanced age (OR 1.11[95% CI 1.01–1.23]) or peri-procedural adverse event (OR 85.0 [95% CI 6.5–118.9]), but not treatment modality (OR 0.39[95% CI 0.08–2.04]), was the predictor of poor neurologic outcome. Conclusions Complementary implementation of both endovascular and open surgery facilitates individualized treatment planning of BAAs. By leveraging strengths of both techniques, equivalent clinical outcomes and technical proficiency may be achieved with both modalities. |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 0942-0940 0001-6268 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::03a7ea476df0ecc7e26039f31f175fa2Test http://europepmc.org/articles/PMC8053658Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....03a7ea476df0ecc7e26039f31f175fa2 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 09420940 00016268 |
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