Surgical Treatment and Outcomes for Basilar Apex Aneurysms

Year 2020, Volume: 73 Issue: 2, 167 - 171, 31.08.2020

Vedat Açık

Abstract

Objectives: Basilar apex aneurysms constitute 5-10% of all intracranial aneurysms. Endovascular and surgical methods are used to treat these aneurysms. Surgical treatment is the gold standard for complete occlusion. Different surgical approaches may be applied depending on the morphological structure of the aneurysm.

Materials and Methods: Thirty-eight basilar apex aneurysms were detected in our institution between October 2017 and January 2020. Sixteen of these patients underwent surgical treatment. The demographic characteristics, angiographic properties, surgical method applied, Glasgow coma scores and Modified Rankin scores (mRS) of the patients were recorded.

Results: Five of the patients were male, 11 were female and the average age was 48.3 years (age range: 20-74 years). While insidental was detected in four of the patients, 12 of them applied with subarachnoid hemorrhage (SAH). As a surgical operation, to nine of them Pterional, to two of them Pretemporal and five of them fronto orbitozygomatic (FROZ) approach were applied. The aneurysm was clipped in all of the patients. In one patient, because the dome of the aneurysm could not be completely closed, wrapping was done. Follow-up angiograms showed that complete occlusion was maintained in all of the aneurysms except the one with wrapping. Two of the patients died. In the follow-up for 2-16 months for the remaining 14 patients, the mRS was 0 in five of the patients, one in six of the patients, two in one of the patients and three in two of the patients.

Conclusion: Basilar apex aneurysms are rare. Various complications may be encountered during endovascular and surgical treatment. Surgical treatment is the superior option to ensure occlusion. Different surgical approaches may be chosen depending on the location and morphological structure of the aneurysm

Keywords

Basilar Apex Aneurysm , Complex Aneurysms , Surgical Treatment

Ethical Statement

Adana City Training and Research Hospital Ethics Committee (date: 03. 04. 2020, no: 902)

Supporting Institution

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Thanks

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Baziler Tepe Anevrizmalarının Cerrahi Tedavisi ve Sonuçları

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