Large Basilar Apex Aneurysms Treated with Flow-Diverter Stents

Area of Science:

• Neurosurgery
• Interventional Neuroradiology
• Vascular Neurology

Background:

• Basilar apex aneurysms, particularly large and wide-neck types, present significant treatment challenges.
• Both endovascular and surgical interventions carry inherent risks and complexities for these specific aneurysms.

Purpose of the Study:

• To evaluate the efficacy and safety of using flow-diverter stents for treating large basilar apex aneurysms.
• To report institutional experience with this endovascular technique in a challenging anatomical location.

Main Methods:

• Retrospective analysis of consecutive patients treated with flow-diverter stents between January 2011 and January 2015.
• Inclusion criteria focused on patients with large basilar apex aneurysms treated with flow-diverter stents.
• Data collected included clinical presentations, procedural details, complications, and midterm clinical and angiographic outcomes.

Main Results:

• Five patients with basilar apex aneurysms were treated with flow-diverter stents, with a mean follow-up of 21 months.
• One patient experienced a fatal midbrain hemorrhage, and another had a transient ischemic event.
• At midterm follow-up, 4 out of 5 patients had a modified Rankin Scale score of 0.

Conclusions:

• Flow diversion is a viable endovascular option for basilar apex aneurysms, demonstrating midterm effectiveness.
• The technique is particularly noted for efficacy in recurrent aneurysms post-prior endovascular treatment.
• Ongoing vigilance regarding the safety profile of flow diversion for these aneurysms is necessary.