Related Experiment Video
Updated: Jul 1, 2026
07:04
Creation of Two Saccular Elastase-Digested Aneurysms with Different Hemodynamics in One Rabbit
Published on: April 15, 2021
Basilar artery trunk saccular aneurysms: morphological characteristics and management
Takashi Higa1, Hiroshi Ujiie, Koichi Kato
1Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan. thiga@nij.twmu.ac.jp
Neurosurgical Review
|September 16, 2008
Summary
Endovascular treatment is recommended as the first choice for basilar artery (BA) trunk aneurysms, offering comparable outcomes to surgery but with fewer complications. This study highlights unique BA aneurysm features and associated vascular anomalies.
Area of Science:
- Neurology
- Vascular Surgery
- Interventional Radiology
Background:
- Basilar artery (BA) trunk saccular aneurysms are rare and can present with complex morphological features.
- Associated vascular anomalies are frequently observed, suggesting a potential underlying mechanism of focal wall weakness.
Purpose of the Study:
- To describe the morphological characteristics of BA trunk saccular aneurysms.
- To report the outcomes of surgical and endovascular treatments for these aneurysms.
Main Methods:
- Retrospective analysis of 22 patients with 22 BA trunk saccular aneurysms.
- Review of surgical (craniotomy for neck clipping) and endovascular interventions.
- Assessment of aneurysm morphology, associated anomalies, and treatment outcomes.
Main Results:
- BA trunk aneurysms exhibited characteristic features: lateral location (41%), multiplicity (32%), and diverse vascular anomalies.
- Most patients presented with subarachnoid hemorrhage; pretreatment neurological status predicted outcomes.
- Endovascular treatment was successful in 10 cases (5 ruptured, 5 unruptured). One case required Hunterian ligation after incomplete embolization.
- Surgical clipping was performed in 11 ruptured aneurysms, with 3 requiring subsequent treatment.
Conclusions:
- Endovascular surgery should be considered the primary treatment for BA trunk saccular aneurysms due to comparable outcomes and lower rates of re-intervention compared to surgery.
- The high incidence of vascular anomalies suggests a congenital or developmental basis for BA aneurysm formation.
Related Concept Videos
01:26Aneurysm III: Interprofessional Care
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
01:30Aneurysm I: Introduction
An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies
Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
01:15Aortic Regurgitation I: Introduction
IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
01:25Aortic Regurgitation III: Medical Management
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
01:22Aneurysm IV: Nursing Management
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...