title: Combined endovascular and surgical treatment of fusiform aneurysms of the basilar artery: technical note.
abstract: BACKGROUND
  To present the combined treatment of fusiform basilar artery aneurysms consisting of a surgical posterior fossa decompressive craniectomy and ventriculoperitoneal (VP) shunt operation at the same sitting, before the endovascular procedure with telescopic stenting of the aneurysmatic vessel segment in four cases.
  
  
  METHODS
  Combined treatment involving surgical procedure consisting of ventriculoperitoneal shunt placement for hydrocephalus and an occipital bone craniectomy and C1 vertebrae posterior laminectomy to decompress the posterior fossa in the same session. After surgery, the patients were loaded with acetylsalicylic acid and clopidogrel, and then the endovascular treatment was performed.
  
  
  RESULTS
  All of the procedures were performed successfully without technical difficulty. The patients tolerated the procedures well and all cases showed remodelling with the overlapping stent technique. The patients were discharged home with baseline neurological situation and computed tomography (CT) angiography was performed at the 3rd month.
  
  
  CONCLUSIONS
  This technique is a safer endovascular approach to treating symptomatic fusiform basilar artery aneurysms by protecting patients from both the haemorrhagic complications of anticoagulant therapy and thrombotic complications due to the interruption of anticoagulant therapy, while treating the hydrocephalus and compression by surgical means.
authors.affiliation: Department of Radiology, Division of Neuroradiology, Istanbul University, Cerrahpasa Medical Faculty, Kocamustafapasa-Istanbul, Turkey, 34098, osmank@istanbul.edu.tr.
authors.forename: Osman
authors.initials: O
authors.lastname: Kizilkilic
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Kayadibi
authors.forename: Galip Zihni
authors.initials: GZ
authors.lastname: Sanus
authors.forename: Naci
authors.initials: N
authors.lastname: Koçer
authors.forename: Civan
authors.initials: C
authors.lastname: Islak
mesh_terms: D000328:Adult; D000368:Aged; D000783:Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D002533:Cerebral Angiography / Q000379:methods; D004621:Embolization, Therapeutic / Q000379:methods; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D015607:Stents; D016896:Treatment Outcome