Styczen, Hanna ORCID: 0000-0002-9623-4156, Fischer, Sebastian, Gawlitza, Matthias, Meyer, Lukas ORCID: 0000-0002-3776-638X, Goertz, Lukas, Maurer, Christoph, Alexandrou, Maria, Khanafer, Ali, Lobsien, Donald, Deuschl, Cornelius, Klisch, Joachim, Kabbasch, Christoph, Fiehler, Jens, Berlis, Ansgar, Papanagiotou, Panagiotis, Henkes, Hans and Maus, Volker . Reconstructive endovascular treatment of basilar artery fenestration aneurysms: A multi-centre experience and literature review. Neuradiology J.. THOUSAND OAKS: SAGE PUBLICATIONS INC. ISSN 2385-1996

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Abstract

Background Data on outcome after endovascular treatment of basilar artery fenestration aneurysms (BAFAs) is limited. This study presents our multi-centre experience of BAFAs treated by different reconstructive techniques including coils, stent-assisted coiling (SAC), flow diversion and intra-saccular flow disruption with the Woven Endobridge (WEB). Methods Retrospective analysis of 38 BAFAs treated endovascularly between 2003 and 2020. The primary endpoint was complete aneurysm obliteration defined as Raymond-Roy occlusion classification (RROC) I on immediate and follow-up (FU) angiography. The secondary endpoints were procedure-related complications, rate of re-treatment, and clinical outcome. Results Endovascular treatment was feasible in 36/38 aneurysms (95%). The most frequent strategy was coiling (21/36, 58%), followed by SAC (7/36, 19%), WEB embolization (6/36, 17%) and flow diversion (2/36, 6%). A successful aneurysm occlusion (defined as RROC 1 and 2) on the final angiogram was achieved in 30/36 (83%) aneurysms including all patients presenting with baseline subarachnoid haemorrhage and 25/36 (69%) were occluded completely. Complete occlusion (RROC 1) was more frequently achieved in ruptured BAFAs (15/25, 60% v. 2/11, 18%; p = 0.031). Procedure-related complications occurred in 3/36 (8%) aneurysms. Re-treatment was executed in 12/36 (33%) aneurysms. After a median angiography FU of 38 months, 30/31 (97%) BAFAs were occluded successfully and 25/31 (81%) showed complete occlusion. Conclusion Reconstructive endovascular treatment of BAFAs is technically feasible with a good safety profile. Although in some cases re-treatment was necessary, a high rate of final aneurysm occlusion was achieved.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Styczen, HannaUNSPECIFIEDorcid.org/0000-0002-9623-4156UNSPECIFIED
Fischer, SebastianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gawlitza, MatthiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Meyer, LukasUNSPECIFIEDorcid.org/0000-0002-3776-638XUNSPECIFIED
Goertz, LukasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Maurer, ChristophUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Alexandrou, MariaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Khanafer, AliUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lobsien, DonaldUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Deuschl, CorneliusUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Klisch, JoachimUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kabbasch, ChristophUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fiehler, JensUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Berlis, AnsgarUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Papanagiotou, PanagiotisUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Henkes, HansUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Maus, VolkerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-598064
DOI: 10.1177/19714009211042877
Journal or Publication Title: Neuradiology J.
Publisher: SAGE PUBLICATIONS INC
Place of Publication: THOUSAND OAKS
ISSN: 2385-1996
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
VERTEBROBASILAR JUNCTION; SACCULAR ANEURYSMS; THERAPYMultiple languages
NeuroimagingMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/59806

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