title: Endovascular treatment of posterior circulation fusiform aneurysms: single-center experience in 31 patients.
abstract: BACKGROUND
  Posterior circulation fusiform aneurysms are rare but difficult to treat.
  
  
  OBJECTIVE
  To report our experience with endovascular treatment of posterior circulation fusiform aneurysms.
  
  
  METHODS
  A retrospective review of our prospectively maintained database identified all posterior circulation fusiform aneurysms treated by endovascular approach over a 6-year period. Clinical charts, procedural data, and angiographic results were reviewed.
  
  
  RESULTS
  From March 2004 to March 2010, 31 patients were identified: 11 asymptomatic patients, 9 who presented with a subarachnoid hemorrhage, 6 with a stroke, and 5 with a mass effect. All but 1 patient (97%), who died before being treated, were successfully treated by parent artery occlusion (n = 10), stenting plus coiling (n = 10), or stenting alone with conventional or flow-diverting stents (n = 10). Twenty-two patients showed a good or an excellent outcome (73%); 3 had a fair or a poor outcome (10%); and 5 patients died (17%). These 8 patients initially presented with severe subarachnoid hemorrhage or mass effect. Procedure-related morbidity includes only one patient who kept a worsening of cranial nerve palsies. There was no definitive procedure-related morbidity or mortality. Immediate aneurysm occlusion was incomplete in 20 cases (67%) and complete in 10 cases (33%). Mean follow-up of 20 months in 23 patients showed 12 further thromboses, 9 stable results, and 2 flow reductions. Final results included 19 complete occlusions (83%) and 4 incomplete occlusions (17%).
  
  
  CONCLUSIONS
  Posterior circulation fusiform aneurysms may be treated by different endovascular approaches with satisfying clinical and anatomical results in most cases. However, patients who present with severe subarachnoid hemorrhage or mass effect still have a poor prognosis.
authors.affiliation: Department of Neuroradiology, Erasme University Hospital, Brussels, Belgium.
authors.forename: Guy
authors.initials: G
authors.lastname: Raphaeli
authors.forename: Laurent
authors.initials: L
authors.lastname: Collignon
authors.forename: Olivier
authors.initials: O
authors.lastname: De Witte
authors.forename: Boris
authors.initials: B
authors.lastname: Lubicz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000783:Aneurysm / Q000601:surgery*; D002533:Cerebral Angiography; D002539:Cerebral Arterial Diseases / Q000601:surgery*; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D055815:Young Adult