ORIGINAL

Endovascular Treatment Modalities for Basilar Artery Aneurysms

Modalidades de Tratamento Endovascular para Aneurismas da Artéria Basilar

  • Leandro José Haas 1    Leandro José Haas 1
  • Guilherme Wandall 1,2    Guilherme Wandall 1,2
  • Wesley Severino 3
  • Amanda Junges Derlam 3
  • Camila Ceruti dos Santos 3
  • Sheila Wayszceyk 3
  • Rafael Destri Coelho 3
  • Eduarda Alves 3
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Resumo

 Introdução: Os aneurismas da artéria basilar são raros e representam 5% de todos os aneurismas cranianos. Devido à sua localização na fossa posterior, a sua evolução associada à hemorragia subaracnóidea é geralmente reservada. O diagnóstico precoce é fundamental para o desfecho e para a redução de complicações. Objetivo: Analisar a história típica de pacientes com aneurisma da artéria basilar tratados com terapia endovascular. Métodos: Estudo observacional, descritivo, de indivíduos com aneurisma da artéria basilar submetidos a tratamento endovascular em um Serviço de Neurocirurgia no período de 2005 a 2022. Resultados: Foram analisados 95 aneurismas. Dois grupos: aneurismas roto e não roto. Grupo sem rutura: prevalência de mulheres (69,47%), faixa etária de 60 a 70 anos, pequenos aneurismas (52,63%) e forma sacular (85,26%). Os aneurismas foram tratados com stents e bobinas. Morbimortalidade de um mês de 3% e de um ano, de 4%. Grupo de aneurisma roto: destacam-se Fisher 4, Hunt-Hess 2 e pacientes do sexo feminino. Após HAS, morbimortalidade em um mês de 14,73%, em um ano, 25,55%. Conclusão: Escolha do tratamento: na fase aguda da HAS, apenas bobinas; em fase tardia ou para aneurismas não rompidos, uma combinação de stent e bobinas.

Palavras-chave

Aneurisma intracraniano; Artéria basilar; Hemorragia subaracnoide; Procedimento endovascular; Neurocirurgia

Abstract

Introdution: Basilar artery aneurysms are rare and account for 5% of all cranial aneurysms. Due to their location in the posterior fossa, their evolution associated with subarachnoid hemorrhage is generally reserved. Early diagnosis is key for the outcome and to reduce complications. Objective: To analyze the typical history of patients with basilar artery aneurysm treated with endovascular therapy. Methods: Observational, descriptive study of individuals with basilar artery aneurysm who underwent endovascular treatment in a Neurosurgery Department from 2005 to 2022. Results: A total of 95 aneurysms was analyzed. Cases were divided into two groups, ruptured and unruptured aneurysms. Unruptured group: prevalence of women (69.47%), age range 60-70, small aneurysms (52.63%), and saccular shape (85.26%). Aneurysms were treated with stents and coils. One-month morbimortality of 3% and one-year, 4%. Ruptured aneurysm group: Fisher 4, Hunt-Hess 2, and female patients stand out. Following SAH, one-month morbimortality of 14.73%, one-year, 25.55%. Conclusion: Choice of treatment: in the acute phase of Subarachnoid Hemorrhage, coils only, and on a late phase or for unruptured aneurysms, a combination of stent and coils.

Keywords

Intracranial aneurysm; Basilar artery; Subarachnoid hemorrhage; Endovascular procedure; Neurosurgery

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1MD, Neurosurgeon, Interventional Neuroradiology specialist, Professor, Universidade Regional de Blumenau, Blumenau, SC, Brasil.

2Endovascular Neurosurgeon, Hospital Santa Isabel, Blumenau, SC, Brasil.

3MS, Medical student, Universidade Regional de Blumenau, Blumenau, SC, Brasil.

 

Received Feb 12, 2024

Accepted May 24, 2024

JBNC  Brazilian Journal of Neurosurgery

JBNC
  •   ISSN (print version): 0103-5118
  •   e-ISSN (online version): 2446-6786
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