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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2017; 75(10): 697-702
DOI: 10.1590/0004-282x20170120
Article

Microsurgical treatment of basilar tip aneurysms: is it still acceptable?

Tratamento cirúrgico dos aneurismas do topo da artéria basilar: ainda uma opção aceitável?
Felix Hendrik Pahl
1   Hospital do Servidor Público Estadual de São Paulo, Departamento de Neurocirurgia
2   IAMSPE, São Paulo SP, Brasil; DFV Neuro, São Paulo SP, Brasil
,
Matheus Fernandes de Oliveira
1   Hospital do Servidor Público Estadual de São Paulo, Departamento de Neurocirurgia
2   IAMSPE, São Paulo SP, Brasil; DFV Neuro, São Paulo SP, Brasil
,
José Marcus Rotta
1   Hospital do Servidor Público Estadual de São Paulo, Departamento de Neurocirurgia
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ABSTRACT

Basilar tip aneurysms (BTAs) have a complex anatomy, making them difficult to treat. We describe our surgical results for BTAs.

Methods: From 2004 to 2015 (12 years), a total of 25 small BTAs and two giant BTAs were treated in the Hospital do Servidor Público Estadual de São Paulo.

Results: In 23 patients harboring aneurysms positioned anteriorly or straight, all aneurysms were clipped (complete exclusion in all on follow-up angiography). In two patients with posteriorly positioned aneurysms, there was residual neck. All patients submitted to surgical treatment of small aneurysms presented with late Glasgow Outcome Scale scores of 4 or 5. Two patients with giant aneurysms died.

Conclusion: Surgical treatment of these lesions may be accomplished with quite high success rates and low morbidity.

RESUMO

Os aneurismas do topo da artéria basilar (BTAs) têm anatomia complexa tornando-os tecnicamente difíceis de serem tratados. Nós descrevemos nossos resultados cirúrgicos em BTAs.

Métodos: De 2004 a 2015 (12 anos), foram tratados no Hospital do Servidor Público Estadual de São Paulo um total de 25 BTAs pequenos e 2 BTAs gigantes.

Resultados: Nos 23 pacientes portadores de aneurismas direcionados anteriormente ou neutros, cem por cento dos aneurismas foram tratados (oclusão de 100% na angiografia de seguimento). Em pacientes com aneurismas direcionados posteriormente (2 pacientes), houve colo residual. Todos os pacientes submetidos ao tratamento cirúrgico de pequenos aneurismas apresentaram Glasgow Outcome Scale (GOS) tardio de 4 ou 5. Nos 2 aneurismas gigantes, houve 2 casos de mortalidade (100%).

Conclusão: Em mãos experientes, o tratamento cirúrgico destas lesões pode ser realizado com taxas de sucesso bastante elevadas e baixa morbidade.

Keywords:

intracranial aneurysm - therapeutics - general surgery - endovascular procedures

Palavras-chave:

aneurisma intracraniano - terapêutica - cirurgia geral - procedimentos endovasculares


Publication History

Received: 09 November 2016

Accepted: 12 July 2017

Article published online:
04 September 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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