Endovascular Treatment of Basilar Aneurysms

A New Window for the Treatment of Posterior Cerebral Artery, Superior Cerebellar Artery, and Basilar Apex Aneurysm: The Expanded Endoscopic Endonasal Approach

“…Nanda et al 5 designated and reported in his clinical series the complex anatomy of a BA aneurysm in which criteria included an aneurysm > 10 cm, calcified or thrombosed, neck ! 4 mm (up to 60% of all BA aneurysms), 4 posterior direction, and retro/subsellar aneurysms. Aneurysms that did not have these criteria were considered simple aneurysms.…”

“…BA aneurysms are the most commonly reported in the posterior cerebral arterial circulation, accounting for 50% 3,4 of all posterior circulation aneurysms. BA aneurysms are associated with higher risk of bleeding, mortality, and morbidity compared with those seen in other posterior circulation locations.…”

A New Window for the Treatment of Posterior Cerebral Artery, Superior Cerebellar Artery, and Basilar Apex Aneurysm: The Expanded Endoscopic Endonasal Approach

“…Discussion and Literature Review BA aneurysms are the most commonly reported in the posterior cerebral arterial circulation, accounting for 50% 3,4 of all posterior circulation aneurysms. BA aneurysms are associated with higher risk of bleeding, mortality, and morbidity compared with those seen in other posterior circulation locations.…”

“…12,13 They arise mainly at the origin of the superior cerebral artery from the basilar artery or between the origin of the superior cerebral and posterior cerebral arteries. 4,13 Compared with BA and posterior cerebral aneurysms, the size of superior cerebellar artery aneurysms are smaller, and they often present with a narrow neck. Additionally, inclusion of the artery origin into the aneurysm has been seen.…”

Keyhole clipping of a low-lying basilar apex aneurysm without posterior clinoidectomy utilizing endoscopic indocyanine green video angiography

“…While the array of endovascular tools used to treat various aneurysms and the proportion of aneurysms treated through such procedures increases, there continues to be a certain subset of patients with BX aneurysms who could benefit from clipping. [18,19] In these patients, it is critical to reduce morbidity while maintaining or improving on the established success of traditional surgical clipping. Intraoperative fluoroscopic indocyanine green video angiography (ICG-VA) is a well described and widely used method to evaluate the vasculature and aneurysm before and after clip placement.…”