State-of-art in surgical treatment of dissecting posterior circulation intracranial aneurysms

Vladimir Balik, Yasuhiro Yamada, Sandeep Talari, Yamashiro Kei, Hirotoshi Sano, Daisuke Suyama, Tukasa Kawase, Kiyoshi Takagi, Katsumi Takizawa, Yoko Kato

研究成果: Review article査読

2 被引用数 (Scopus)

抄録

Vertebrobasilar (VB) intracranial dissecting aneurysms (IDAs) pose difficult therapeutic issues and are especially among the most difficult to manage surgically. There are, however, some cases where selective aneurysm obliteration by endovascular approach is impossible or is associated with an unacceptable risk of morbidity. This is particularly true when the aneurysm is dissecting, giant, or has a large neck. In such cases, surgical treatment may be the only alternative. Optimal management of these lesions is therefore challenging and treatment decisions have to be made on a case-by-case basis. Ideal treatment should be a complete surgical excision of the lesion; however, this procedure might only be possible after distal and proximal vessel wall occlusion which might not be tolerated by the patient depending on the location of the aneurysm. Therefore, formulation of recommendations concerning the surgical strategy remains still difficult due to inconsistency of surgical outcomes. The literature describing surgical strategy of VB IDAs is varying in quality and content, and many studies deal with only a few patients. In the presented review, the authors summarize the current knowledge on the incidence, pathogenesis, clinical presentation, and diagnostic procedures with special emphasis on surgical treatment of IDAs in posterior circulation.

本文言語English
ページ(範囲)31-45
ページ数15
ジャーナルNeurosurgical Review
41
1
DOI
出版ステータスPublished - 01-01-2018

All Science Journal Classification (ASJC) codes

  • 外科
  • 臨床神経学

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