ORIGINAL RESEARCH article
Front. Neurol.
Sec. Endovascular and Interventional Neurology
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1628676
Complications and long-term outcomes after endovascular treatment of basilar trunk aneurysms
Provisionally accepted
- 1Department of Neurosurgery, First Hospital of Jilin University, Changchun, China
- 2Department of radiotherapy, Third Hospital of Jilin University, changchun, China
- 3School of Nursing, Jilin University, Changchun, China
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Basilar trunk aneurysms (BTAs) are rare and challenging to treat, with a high complication rate. This study aimed to analyze and evaluate the complications and longterm outcomes associated with endovascular treatment (EVT) of BTAs and identify risk factors for postprocedural complications and unfavorable clinical outcomes. Methods: This retrospective, observational cohort study included 90 patients (92 BTAs) treated with EVTs from January 2011 to April 2023. Factors associated with postprocedural complications and unfavorable clinical outcomes were analyzed.Results: All 90 patients (92 aneurysms) were successfully treated, of which 63 (68.5%) aneurysms were small, 26 (28.3%) were large, and 3 (3.3%) were giant; 23 (25%) were saccular, and 69 (75%) were fusiform and/or dissecting. A total of 36 (40.0%) patients were admitted with ruptured aneurysm. The median follow-up duration was 51.0 months (IQR 21.0-73.0). The favorable clinical outcome rate was 75.6% (68/90). The overall complication rate was 33.33% (30/90), with ischemic and hemorrhagic complications occurring in 25.6% (23/90) and 2.2% (2/90) of cases, respectively. The mortality rate was 8.9% (8/90). Unilateral vertebral artery sacrifice (P=0.015), Glasgow Coma Scale (GCS) grade ≤12 before the procedure (P<0.047), and age ≥60 years (P=0.006) were associated with overall postprocedural complications. Diabetes mellitus (P=0.002), ischemic onset (P=0.005), aneurysms involving the vertebrobasilar junction (P=0.025), and GCS grade ≤12 before the procedure (P<0.001) were risk factors for unfavorable clinical outcomes. Cumulative survival rates at 1, 3, and 5 years were 95.4%, 92.1%, and 87.9%, respectively. The cumulative complication-free survival rates were 72.1%, 68.3%, and 64.5%, respectively. Angiographic follow-up revealed complete occlusion in 71.7% (33/46).EVT for BTAs appears feasible and yields favorable clinical outcomes at the last follow-up, with reasonable cumulative survival rates at 1, 3, and 5 years.However, clinicians should be vigilant for procedure-related complications, particularly ischemic complications, which may lead to poor outcomes or death.
Keywords: Intracranial Aneurysm, basilar aneurysms, endovascular treatment, Basilar trunk artery, complication
Received: 14 May 2025; Accepted: 11 Aug 2025.
Copyright: © 2025 Bi, Tian, Chi, Chen, Song, Chen, Yang and Zhou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jing Zhou, Department of Neurosurgery, First Hospital of Jilin University, Changchun, China
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