Background
Management of intracranial basilar dissecting aneurysms has been controversial and
challenging, and surgical and conservative treatments usually have a bad prognosis.
Our study aimed at evaluating the outcomes of endovascular treatment for these lesions
and exploring the predictors of favorable outcome.
Methods
We retrospectively reviewed 50 consecutive patients with basilar dissecting aneurysms
from January 2006 to January 2013. Twenty-four patients underwent stent-assisted coiling
whereas 26 patients underwent conservative treatment. Follow-up outcomes were evaluated
using modified Rankin Scale (mRS) score.
Results
Of the patients treated with stent-assisted coiling, 20 patients had a favorable outcome
(mRS score, 0-1), post-treatment recurrence occurred in 3 patients, 1 had rebleeding,
and 2 had no rebleeding. Of the patients treated with conservative therapy (observation
or anticoagulation), 10 patients had an unfavorable outcome, 2 patients with ruptured
aneurysms developed rebleeding, and 8 patients had poor outcome because of infarct
progression. Stent-assisted coiling group had a more favorable outcome than the conservatively
treated group (83.3% versus 55.2%, P = .019). Initial complete obliteration was related to the favorable outcome in endovascular-treated
group (P = .042). Stent placement was the only independent predictor of favorable outcome
in the logistic regression analysis (P = .030; odds ratio = 5.828; 95% confidence interval, 1.192-28.503).
Conclusions
Patients with basilar artery dissecting aneurysms treated with stent-assisted coiling
had a more favorable outcome than the conservatively treated patients. Stent placement
and initial complete occlusion were the favorable factors in patients with basilar
dissecting aneurysm.
Key Words
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Article info
Publication history
Published online: June 13, 2015
Accepted:
May 13,
2015
Received in revised form:
May 8,
2015
Received:
January 25,
2015
Footnotes
The authors have no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article.
This work was supported by the 2012 National Science Foundation of China (grant No 81271315).
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.05.013
Copyright
© 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.
