Interventional embolization of aneurysms located at basilar artery apex: clinical therapeutic strategies

Objective: To analyze and to summarize the therapeutic safety and efficacy of interventional embolization for aneurysms located at basilar artery apex of posterior circulation. Methods: The clinical data of 21 patients with basilar artery apex aneurysm, who were admitted to authors' hospital during the period from November 2008 to March 2015 to receive interventional embolization therapy, were retrospectively analyzed. Before treatment, the aneurysm was confirmed to be situated at the apex of basilar artery by DSA examination in all patients. Of the 21 patients, Hunt-Hess grade 0-II of clinical aneurysm classification was seen in 12 and Hunt-Hess grade III-IV was observed in 9. Interventional embolization with detachable coils only was performed in 16 patients and embolization with stent-assisted detachable coils in 5 patients. Results: Complete dense embolization (100% embolization) was achieved in 17 patients, while almost complete embolization (95% embolization) was obtained in 4 patients. No aneurysm rupture occurred during embolization procedure. Glasgow Outcome Scale (GOS) was used to evaluated the lesions: the preoperative GOS scores of 15, 13-14, 9-12 and 3-8 points were seen in 9, 3, 2 and 7 patients respectively; and the postoperative GOS scores of 15, 13-14 and 3-8 points were seen in 13, 5 and 37 patients respectively. After the operation 18 patients were followed up for 6-48 months, and no recurrence was observed in 15 patients, and a relapse of aneurysm at 6 and 12 months after operation was seen in 2 patients and one patient respectively. No re-bleeding was seen in all patients. Conclusion: Interventional embolization is a safe and effective treatment for aneurysms located at basilar artery apex. (authors)