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CZECH MEDICAL ASSOCIATION J. Ev. PURKYNĚ |
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Česky / Czech version | Čes. a Slov. Neurol. Neurochir., 64/97, 2001, No. 5, p. 285-294 |
Surgical or Interventional Neuroradiological Treatment of
Vertebrobasilar Aneurysms? Pogády P., Trenkler J. O. Ö. Landesnervenklinik Wagner-Jauregg, Neurochirurgické oddelenie, Linz, O. Ö. Landesnervenklinik Wagner-Jauregg, Neuroradiologické oddelenie, Linz |
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Summary: The study evaluates retrospectively 10 years’ experience with the treatment of vertebrobasilar aneurysms in 72 patients. During the last four years in addition to microsurgical methods also interventional
neuroradiology was used. From a total number of 72 patients in 19 a vertebrobasilar aneurysm was
eliminated from the circulation by GDC coiling and in one instance by means of a stent. In the thus
non-selected group of patients the total mortality without differentiation between stages of haemorrhage and the type of therapy was 15.3% (11 patients). 11 pacients (15.3%) had a severe neurological
deficit and one patient (1.4%) in stage III-IV was in a vegetative state. Of 31 patients in stage I-II one
patient died. Two patients (6.4%) had a severe neurological deficit. Of 25 patients in stage III-IV 10
patients died (40%) and 8 patients (32%) had a severe neurological deficit. In the group without
subarachnoidal haemorrhage the mortality was zero and one patient had a severe neurological deficit.
The results of alternative treatment (clipping-endovascular therapy) are not considered worse by the
authors than isolated microsurgical treatment. In indicated cases methods of interventional neuroradiology are not only a therapeutic alternative but the only possibility. The two methods are comple -
mentary. The extensive elaboration of microneuroanatomy and microsurgical approaches has attained
already its peak. This important stage will be followed by the period of an alternative interdisciplinary
approach. The presented work respects this trend in the treatment of aneurysms.
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