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Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
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Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms

Published on: August 11, 2015

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Clinical Outcomes of Large (>10 mm) Unruptured Posterior Circulation Aneurysms and Their Predictors

Joonho Byun1, Wonhyoung Park1, Jung Cheol Park1

  • 1Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Journal of Korean Neurosurgical Society
|December 23, 2020
PubMed

Insights

Treatment for large posterior circulation aneurysms is complex. While both transcranial surgery and endovascular treatment (EVT) have similar complication rates and obliteration success, surgery offers better long-term durability.

Area of Science:

  • Neurosurgery
  • Vascular Neurology
  • Interventional Radiology

Background:

  • Large aneurysms in the posterior circulation present significant treatment challenges.
  • Managing these complex vascular lesions requires careful consideration of risks and benefits.

Purpose of the Study:

  • To analyze institutional clinical outcomes for patients with large, unruptured posterior circulation aneurysms.
  • To compare the efficacy and safety of transcranial surgery versus endovascular treatment (EVT).

Main Methods:

  • Retrospective analysis of 56 patients with large (>10 mm) unruptured posterior circulation aneurysms (2002-2018).
  • Patients were treated with either transcranial surgery or EVT.
  • Outcomes including complications, obliteration rates, recurrence, and functional status were assessed.

Main Results:

  • No significant difference in post-treatment complications or complete obliteration rates between transcranial surgery and EVT.
  • Higher recurrence rates were observed with EVT compared to transcranial surgery (39.5% vs. 11.1%, p=0.03).
  • 84% of patients achieved a favorable functional outcome; EVT was a negative predictor of worsening functional status in saccular aneurysms.

Conclusions:

  • Treatment of large posterior circulation aneurysms carries a high risk of morbidity.
  • Transcranial surgery demonstrated superior treatment durability compared to EVT, despite similar complication and obliteration rates.
  • Surgical intervention may be preferred for long-term durability in select cases.
Abstract

Keywords:
Aneurysm, Large, UnrupturedComplicationsPosterior circulationSurgeryTreatment outcome

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