Natural history and management of basilar trunk artery aneurysms.

Détails

ID Serval
serval:BIB_CDBF4D71D150
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Natural history and management of basilar trunk artery aneurysms.
Périodique
Stroke
Auteur⸱e⸱s
Saliou G., Sacho R.H., Power S., Kostynskyy A., Willinsky R.A., Tymianski M., terBrugge K.G., Rawal S., Krings T.
ISSN
1524-4628 (Electronic)
ISSN-L
0039-2499
Statut éditorial
Publié
Date de publication
04/2015
Peer-reviewed
Oui
Volume
46
Numéro
4
Pages
948-953
Langue
anglais
Notes
Saliou, Guillaume
Sacho, Raphael H
Power, Sarah
Kostynskyy, Alex
Willinsky, Robert A
Tymianski, Michael
terBrugge, Karel G
Rawal, Sapna
Krings, Timo
eng
Research Support, Non-U.S. Gov't
2015/02/26 06:00
Stroke. 2015 Apr;46(4):948-53. doi: 10.1161/STROKEAHA.114.006909. Epub 2015 Feb 24.
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Résumé
Basilar trunk aneurysms (BTAs), defined as aneurysms distal to the basilar origin and proximal to the origin of the superior cerebellar artery, are rare and challenging to manage. We describe the natural history and management in a consecutive series of BTAs.
Between 2000 and 2013, 2522 patients with 3238 aneurysms were referred to our institution for aneurysm management. A retrospective review of this database was conducted to identify all patients with BTAs.
In total, 52 patients had a BTA. Mean age was 56 (SD±18) years. Median clinical follow-up was 33 (interquartile range, 8-86) months, and imaging follow-up was 26 (interquartile range, 2-80.5) months. BTAs were classified into 4 causal subtypes: acute dissecting aneurysms, segmental fusiform ectasia, mural bleeding ectasia, and saccular aneurysms. Multiple aneurysms were more frequently noticed among the 13 saccular aneurysms when compared with overall population (P=0.021). There was preponderance of segmental ectasia or mural bleeding ectasia (P=0.045) in patients presenting with transit ischemic attack/stroke or mass effect. Six patients with segmental and 4 with mural bleeding ectasia demonstrated increasing size of their aneurysm, with 2 having subarachnoid hemorrhage caused by aneurysm rupture. None of the fusiform aneurysms that remained stable bled.
BTAs natural histories may differ depending on subtype of aneurysm. Saccular aneurysms likely represent an underlying predisposition to aneurysm development because more than half of these cases were associated with multiple intracranial aneurysms. Intervention should be considered in segmental ectasia and chronic dissecting aneurysms, which demonstrate increase in size over time as there is an increased risk of subarachnoid hemorrhage.

Mots-clé
Adult, Aged, Aged, 80 and over, Aneurysm, Dissecting/pathology, Aneurysm, Dissecting/therapy, Basilar Artery/pathology, Dilatation, Pathologic/pathology, Dilatation, Pathologic/therapy, Disease Progression, Disease Susceptibility, Female, Humans, Intracranial Aneurysm/classification, Intracranial Aneurysm/pathology, Intracranial Aneurysm/therapy, Male, Middle Aged, Retrospective Studies
Pubmed
Open Access
Oui
Création de la notice
20/01/2017 15:30
Dernière modification de la notice
20/08/2019 15:48
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