Quantitative volumetric and lesion length analysis for evaluating the severity of intracranial vertebrobasilar...

Vertebrobasilar dolichoectasia (VBD) is a rare disease, and the pathogenesis and factors associated with its prognosis are still unclear. Despite the high incidence of enlargement, rupture, and ischemia, the therapeutic indication and strategy of VBD remain unestablished. This study aimed to identify the factors associated with the outcome of VBD and to investigate its current treatment.

We retrospectively reviewed patients who were diagnosed with VBD at 39 institutions in Japan between 2010 and 2019.

A total of 114 cases were collected, and 96 cases were included in the analysis. The median age of the patients was 65 years, the median follow-up was 2.7 years, and the median time from the initial diagnosis was 5.0 years. A total of 40.3% of patients had a modified Rankin Scale (mRS) scale of 0-2, and 42.3% of patients had a mRS score of 5-6. In a multivariate analysis, a shorter lesion length (P = 0.033) and smaller vertebrobasilar (VB) artery volume (P = 0.008) were significantly associated with a favorable outcome. A longer lesion length (P = 0.004), larger VB artery volume (P = 0.045), and therapeutic intervention for an aneurysm (P = 0.04) were significantly associated with unfavorable outcomes.

The lesion length and VB artery volume are independent factors associated with the outcome of VBD. The treatment of aneurysms is still challenging, and indications for treatment should be carefully determined.