gms | German Medical Science

55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

Article

Send article

Interdisciplinary treatment of vertebral artery and posterior inferior cerebellar artery aneurysms

Die interdisziplinäre Behandlung von Aneurysmen der Arteria vertebralis und Arteria cerebelli inferior posterior

Meeting Abstract

Search Medline for

  • corresponding author I. Erol Sandalcioglu - Neurochirurgische Klinik, Universitätsklinikum Essen, Essen
  • I. Wanke - Neuroradiologische Abteilung, Universitätsklinikum Essen, Essen
  • B. Schoch - Neurochirurgische Klinik, Universitätsklinikum Essen, Essen
  • T. Gasser - Neurochirurgische Klinik, Universitätsklinikum Essen, Essen
  • J. P. Regel - Neurochirurgische Klinik, Universitätsklinikum Essen, Essen
  • A. Doerfler - Neuroradiologische Abteilung, Universitätsklinikum Essen, Essen
  • M. Forsting - Neuroradiologische Abteilung, Universitätsklinikum Essen, Essen
  • D. Stolke - Neurochirurgische Klinik, Universitätsklinikum Essen, Essen

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocDI.08.10

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2004/04dgnc0232.shtml

Published: April 23, 2004

© 2004 Sandalcioglu et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective

To describe the clinical results in patients with aneurysms of the vertebral artery and posterior inferior cerebellar artery complex (VA-PICA) treated by endovascular embolization or surgically in cases considered untreatable by endovascular methods.

Methods

During a 5 year period a total of 28 out of 600 patients with a VA-PICA complex aneurysm received definitive treatment in our institution, 19 patients by endovascular embolization and 9 patients surgically. Mean age was 54 years (range 9 - 75 years). Clinical data, intraoperative observations and procedural complications were evaluated. The mean follow-up period was 9 months.

Results

Hunt-Hess (HH) grades were HH 0-II in 10 patients (35.7 %), HH III in 6 patients (21.4 %) and HH IV+V in 12 patients (42.9 %). Aneurysm size ranged from 2 to 40 mm (mean size 5.5 mm). Aneurysm configuration was saccular 17, fusiform 7 and multilobed 3. Complete occlusion was achieved in all cases. Overall 67.9 % (n = 19) showed a favorable outcome (Glasgow Outcome Score IV + V). Overall procedure-related rate for permanent morbidity and mortality was 3.6 % (n = 1) and 3.6 % (n = 1), respectively. Predictive factors of clinical outcome were the initial clinical HH grade (p = 0.01) and the Fisher grade (p = 0.057).

Conclusions

Endovascular embolization is an effective method in the treatment of VA-PICA aneurysms. Surgical clipping is still an alternative for “uncoilable” lesions.