Does embryologic basilar fusion type impact basilar apex aneurysm treatment outcomes?

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Clinical Neuroscience Pub Date : 2025-09-26 DOI:10.1016/j.jocn.2025.111632

Zachary Hubbard , Julio Isidor , Hidetoshi Matsukawa , Rahim Abo Kasem , Conor Cunningham , Hasna Loulida , Mohammad Mahdi Bagheri Asl , Mohammad Mahdi Sowlat , Shinichi Yoshimura , Alejandro Spiotta

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Abstract

Background and Objectives

Basilar apex aneurysms can be challenging entities for both open and endovascular treatment. The basilar artery forms from fusion of the paired longitudinal neural arteries that produces several anatomical morphologies known to correlate with basilar aneurysm formation. There is paucity of literature on these morphologic types on aneurysm treatment. The aim of this study was to examine endovascular treatment outcomes of basilar apex aneurysms based on embryologic fusion type.

Methods

We performed a retrospective review of aneurysm databases from one American and one Japanese institution for basilar apex aneurysms treated using endovascular modalities. Angiographic studies were reviewed, and embryologic fusion type was assigned. Outcomes of interest included treatment type, angiographic and complications.

Results

151 patients were included in the analysis. There were 76 patients (50.3 %) with cranial fusion, 28 patients (18.6 %) with caudal fusion, and 47 patients (31.1 %) with asymmetric fusion. Mean aneurysm height was largest in the asymmetric fusion group (5.2 mm; [IQR] 3.7–7.0) compared to cranial (4.3 mm; [IQR] 2.9–5.8) and caudal (4.8 mm; [IQR] 3.5–8.0) groups (p = 0.03). Treatment modality did not differ among embryologic fusion types; stent assisted coil embolization was the most frequent treatment modality (58.9 %). There were no differences in complication rates between groups. One-year complete occlusion rates were lowest in the asymmetric fusion group (40.7 %) and highest in the cranial fusion group (72.9 %) (p = 0.03).

Conclusion

There are differences in one-year complete occlusion rates following endovascular treatment of basilar apex aneurysms among varying embryologic fusion types. Asymmetric fusion is associated with the lowest complete occlusion rate. Embryologic fusion type may portend differences in outcomes among patients undergoing treatment for basilar apex aneurysms.

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胚胎基底动脉融合类型是否影响基底动脉尖动脉瘤的治疗效果？

背景与目的颅底动脉瘤是一个具有挑战性的实体，无论是开放治疗还是血管内治疗。基底动脉由成对的纵向神经动脉融合形成，产生几种已知与基底动脉瘤形成相关的解剖形态。关于这些形态类型的动脉瘤治疗的文献很少。本研究的目的是探讨基于胚胎融合类型的基底顶动脉瘤的血管内治疗结果。方法回顾性分析了美国和日本两家机构关于血管内治疗基底顶动脉瘤的数据。回顾了血管造影研究，并确定了胚胎融合类型。结果包括治疗方式、血管造影和并发症。结果151例患者纳入分析。颅骨融合76例（50.3 %），尾骨融合28例（18.6 %），非对称融合47例（31.1 %）。非对称融合组的平均动脉瘤高度最大（5.2 mm; [IQR] 3.7-7.0），高于颅骨组（4.3 mm; [IQR] 2.9-5.8）和尾侧组（4.8 mm; [IQR] 3.5-8.0）（p = 0.03）。不同胚胎融合类型的治疗方式无差异；支架辅助线圈栓塞是最常见的治疗方式（58.9 %）。两组间并发症发生率无差异。非对称融合组一年完全咬合率最低（40.7 %），颅骨融合组一年完全咬合率最高（72.9 %）（p = 0.03）。结论不同胚胎融合类型的基底尖动脉瘤血管内治疗后1年完全闭塞率存在差异。不对称融合与最低的完全咬合率相关。胚胎融合类型可能预示着基底顶动脉瘤患者治疗结果的差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Neuroscience 医学-临床神经学

CiteScore

4.50

自引率

0.00%

发文量

402

审稿时长

40 days

期刊介绍： This International journal, Journal of Clinical Neuroscience, publishes articles on clinical neurosurgery and neurology and the related neurosciences such as neuro-pathology, neuro-radiology, neuro-ophthalmology and neuro-physiology. The journal has a broad International perspective, and emphasises the advances occurring in Asia, the Pacific Rim region, Europe and North America. The Journal acts as a focus for publication of major clinical and laboratory research, as well as publishing solicited manuscripts on specific subjects from experts, case reports and other information of interest to clinicians working in the clinical neurosciences.