title: A challenging entity of unruptured giant saccular aneurysms of vertebrobasilar artery.
abstract: OBJECTIVE
  Giant intracranial aneurysms commonly cause poor clinical outcome and few studies focus on them. This study is to retrospectively report the angiographic and clinical presentations in unruptured giant saccular vertebrobasilar aneurysms with and without endovascular treatment.
  
  
  METHODS
  Out of 400 patients who had unruptured posterior circulation aneurysms in a single center, we found 10 unruptured giant (>25mm) saccular vertebrobasilar aneurysms. Clinical and angiographic presentations as well as their clinical outcomes were assessed.
  
  
  RESULTS
  Of the 10 giant aneurysms in 10 patients, three were left untreated. During 6 months follow-up, all 3 of these patients died from aneurysm rupture. The remaining 7 patients were treated by endovascular procedure, 5 received stent-assisted coiling, 1 was treated by parent artery occlusion (PAO), and 1 was treated by conventional coiling. Of these treated patients, only one survived during a 22 month period of follow-up.
  
  
  CONCLUSIONS
  Patients with giant saccular aneurysms of vertebrobasilar artery presenting mass effect may have extremely poor clinical outcomes and may not benefit from endovascular treatment.
authors.affiliation: Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Beijing Engineering Research Center for Interventional Neuroradiology, Capital Medical University, Beijing, PR China.
authors.forename: Huijian
authors.initials: H
authors.lastname: Ge
authors.affiliation: Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Beijing Engineering Research Center for Interventional Neuroradiology, Capital Medical University, Beijing, PR China. Electronic address: liyouxiang@263.net.
authors.forename: Youxiang
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Beijing Engineering Research Center for Interventional Neuroradiology, Capital Medical University, Beijing, PR China.
authors.forename: Xianli
authors.initials: X
authors.lastname: Lv
mesh_terms: D000328:Adult; D000368:Aged; D000783:Aneurysm / Q000000981:diagnostic imaging* / Q000628:therapy; D001488:Basilar Artery / Q000000981:diagnostic imaging*; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Clinical outcomes; Endovascular treatment; Giant saccular aneurysms; Unruptured aneurysms; Vertebrobasilar artery