Treatment of Symptomatic Dolichoectatic Vertebrobasilar Aneurysms: A Single-Center Experience with 12 Patients

To report our single-center experience in the treatment of dolichoectatic vertebrobasilar aneurysms.

We retrospectively reviewed the data, including clinical features, strategies of managing aneurysms, and follow-up results, of 12 patients who were treated at the Tainjin Huanhu Hospital.

Of the 12 patients, 1 patient was treated with medication, 4 patients were treated using stent reconstruction, and 7 patients were treated via revascularization (open surgery). The clinical symptoms of the patients who were treated with medication and stent reconstruction were stable. The patients who were treated with revascularization suffered from pneumonia, and 1 patient who presented with intracranial hematoma was treated via a second craniotomy. One patient suffered from new cerebral infraction. Postoperative follow-up from 5 to 67 months indicated that 2 patients (16.7%) had died (modified Rankin Scale [mRS] score of 6), and both were treated with revascularization. Seven patients had mRS scores of 0-2, and the other 3 patients had mRS scores of 4-5.

If the condition of the patients is stable and benign, they can be treated with medication or stent reconstruction. Given the serious complications that can be caused by open surgery, care must be taken when selecting the patients to be treated using open surgery, but more studies are needed to support this conclusion. The key points are to avoid aneurysm thrombosis and maintain patency of the perforators.