Reconstructive endovascular treatment of basilar artery fenestration aneurysms: A multi-centre experience and literature review
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Reconstructive endovascular treatment of basilar artery fenestration aneurysms: A multi-centre experience and literature review. / Styczen, Hanna; Fischer, Sebastian; Gawlitza, Matthias; Meyer, Lukas; Goertz, Lukas; Maurer, Christoph; Alexandrou, Maria; Khanafer, Ali; Lobsien, Donald; Deuschl, Cornelius; Klisch, Joachim; Kabbasch, Christoph; Fiehler, Jens; Berlis, Ansgar; Papanagiotou, Panagiotis; Henkes, Hans; Maus, Volker.
In: NEURORADIOL J, Vol. 35, No. 3, 06.2022, p. 319-328.Research output: SCORING: Contribution to journal › SCORING: Review article › Research
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TY - JOUR
T1 - Reconstructive endovascular treatment of basilar artery fenestration aneurysms: A multi-centre experience and literature review
AU - Styczen, Hanna
AU - Fischer, Sebastian
AU - Gawlitza, Matthias
AU - Meyer, Lukas
AU - Goertz, Lukas
AU - Maurer, Christoph
AU - Alexandrou, Maria
AU - Khanafer, Ali
AU - Lobsien, Donald
AU - Deuschl, Cornelius
AU - Klisch, Joachim
AU - Kabbasch, Christoph
AU - Fiehler, Jens
AU - Berlis, Ansgar
AU - Papanagiotou, Panagiotis
AU - Henkes, Hans
AU - Maus, Volker
PY - 2022/6
Y1 - 2022/6
N2 - BACKGROUND: Data on outcome after endovascular treatment of basilar artery fenestration aneurysms (BAFAs) is limited. This study presents our multi-centre experience of BAFAs treated by different reconstructive techniques including coils, stent-assisted coiling (SAC), flow diversion and intra-saccular flow disruption with the Woven Endobridge (WEB).METHODS: Retrospective analysis of 38 BAFAs treated endovascularly between 2003 and 2020. The primary endpoint was complete aneurysm obliteration defined as Raymond-Roy occlusion classification (RROC) I on immediate and follow-up (FU) angiography. The secondary endpoints were procedure-related complications, rate of re-treatment, and clinical outcome.RESULTS: Endovascular treatment was feasible in 36/38 aneurysms (95%). The most frequent strategy was coiling (21/36, 58%), followed by SAC (7/36, 19%), WEB embolization (6/36, 17%) and flow diversion (2/36, 6%). A successful aneurysm occlusion (defined as RROC 1 and 2) on the final angiogram was achieved in 30/36 (83%) aneurysms including all patients presenting with baseline subarachnoid haemorrhage and 25/36 (69%) were occluded completely. Complete occlusion (RROC 1) was more frequently achieved in ruptured BAFAs (15/25, 60% v. 2/11, 18%; p = 0.031). Procedure-related complications occurred in 3/36 (8%) aneurysms. Re-treatment was executed in 12/36 (33%) aneurysms. After a median angiography FU of 38 months, 30/31 (97%) BAFAs were occluded successfully and 25/31 (81%) showed complete occlusion.CONCLUSION: Reconstructive endovascular treatment of BAFAs is technically feasible with a good safety profile. Although in some cases re-treatment was necessary, a high rate of final aneurysm occlusion was achieved.
AB - BACKGROUND: Data on outcome after endovascular treatment of basilar artery fenestration aneurysms (BAFAs) is limited. This study presents our multi-centre experience of BAFAs treated by different reconstructive techniques including coils, stent-assisted coiling (SAC), flow diversion and intra-saccular flow disruption with the Woven Endobridge (WEB).METHODS: Retrospective analysis of 38 BAFAs treated endovascularly between 2003 and 2020. The primary endpoint was complete aneurysm obliteration defined as Raymond-Roy occlusion classification (RROC) I on immediate and follow-up (FU) angiography. The secondary endpoints were procedure-related complications, rate of re-treatment, and clinical outcome.RESULTS: Endovascular treatment was feasible in 36/38 aneurysms (95%). The most frequent strategy was coiling (21/36, 58%), followed by SAC (7/36, 19%), WEB embolization (6/36, 17%) and flow diversion (2/36, 6%). A successful aneurysm occlusion (defined as RROC 1 and 2) on the final angiogram was achieved in 30/36 (83%) aneurysms including all patients presenting with baseline subarachnoid haemorrhage and 25/36 (69%) were occluded completely. Complete occlusion (RROC 1) was more frequently achieved in ruptured BAFAs (15/25, 60% v. 2/11, 18%; p = 0.031). Procedure-related complications occurred in 3/36 (8%) aneurysms. Re-treatment was executed in 12/36 (33%) aneurysms. After a median angiography FU of 38 months, 30/31 (97%) BAFAs were occluded successfully and 25/31 (81%) showed complete occlusion.CONCLUSION: Reconstructive endovascular treatment of BAFAs is technically feasible with a good safety profile. Although in some cases re-treatment was necessary, a high rate of final aneurysm occlusion was achieved.
KW - Basilar Artery/diagnostic imaging
KW - Cerebral Angiography
KW - Embolization, Therapeutic/methods
KW - Endovascular Procedures/methods
KW - Follow-Up Studies
KW - Humans
KW - Intracranial Aneurysm/diagnostic imaging
KW - Multicenter Studies as Topic
KW - Retrospective Studies
KW - Stents
KW - Treatment Outcome
U2 - 10.1177/19714009211042877
DO - 10.1177/19714009211042877
M3 - SCORING: Review article
C2 - 34476993
VL - 35
SP - 319
EP - 328
JO - NEURORADIOL J
JF - NEURORADIOL J
SN - 1971-4009
IS - 3
ER -