Flow diversion for basilar quadrifurcation aneurysms

Authors

Visish M. Srinivasan, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA.
Jubran H. Jubran, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA.Follow
Henry O. Stonnington, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA.
Joshua S. Catapano, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA.Follow
Lea Scherschinski, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA.
Benjamin K. Hendricks, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA.Follow
Ethan A. Winkler, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA.
Robert F. Rudy, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA.
Brandon A. Nguyen, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA.
Stephen J. Dabrowski, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA.
Ashutosh P. Jadhav, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA.Follow
Andrew F. Ducruet, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA.
Felipe C. Albuquerque, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA Felipe.Albuquerque@barrowbrainandspine.com.Follow

Document Type

Article

Abstract

BACKGROUND: Flow-diverting devices (FDDs), such as the Pipeline Embolization Device, have been gaining traction for treating challenging posterior circulation aneurysms. Few previous studies have focused on using FDDs to treat aneurysms of the basilar quadrifurcation. METHODS: We retrospectively reviewed the use of FDDs to treat patients with basilar quadrifurcation aneurysms. Patients were assessed for aneurysm type, previous aneurysm treatment, technical success, periprocedural complications, and long-term aneurysm occlusion. RESULTS: 34 patients were assessed; aneurysms of the basilar apex (n=23) or superior cerebellar artery (SCA) (n=7), or both (n=1), and posterior cerebral artery (PCA) (n=3). The mean (SD) largest aneurysm dimension was 8.7 (6.1) mm (range 1.9-30.8 mm). 14 aneurysms were previously surgically clipped or endovascularly coiled. All aneurysms had a saccular morphology. Complete or near-complete occlusion was achieved in 30 of 34 patients (88%) at final angiographic follow-up, a mean (SD) of 6.6 (5.4) months (range 0-19 months) postoperatively. No patient experienced postoperative symptomatic occlusions of the SCA or PCA; 4 patients developed asymptomatic posterior communicating artery occlusions; 28 patients (82%) experienced no complications; whereas 3 (9%) experienced major complications and 3 (9%) experienced minor complications; and 1 patient died as a result of subarachnoid hemorrhage. CONCLUSION: Flow diversion may be a safe and effective option to treat basilar quadrifurcation aneurysms. Previously treated basilar quadrifurcation aneurysms with recurrence or residual lesion may benefit from additional treatment with an FDD. Further prospective studies should be directed toward validating these findings.

Publication Date

5-30-2023

Publication Title

Journal of neurointerventional surgery

E-ISSN

1759-8486

PubMed ID

37253595

Digital Object Identifier (DOI)

10.1136/jnis-2022-019238

Recommended Citation

Srinivasan, Visish M.; Jubran, Jubran H.; Stonnington, Henry O.; Catapano, Joshua S.; Scherschinski, Lea; Hendricks, Benjamin K.; Winkler, Ethan A.; Rudy, Robert F.; Nguyen, Brandon A.; Dabrowski, Stephen J.; Jadhav, Ashutosh P.; Ducruet, Andrew F.; and Albuquerque, Felipe C., "Flow diversion for basilar quadrifurcation aneurysms" (2023). Translational Neuroscience. 2258.
https://scholar.barrowneuro.org/neurobiology/2258