探讨采用单纯血流导向装置（flow diverter，FD）置入治疗未破裂基底动脉主干大型动脉瘤（large basilar trunk aneurysms，LBTAs）的安全性及疗效。

回顾性纳入哈尔滨医科大学附属第一医院自2015年1月至2023年8月采用单纯FD置入治疗未破裂基底动脉主干大型动脉瘤（最大径≥10 mm）的患者。评估术后患者的并发症发生情况及随访影像学结果。采用改良Rankin量表评分（modified Rankin scale，mRS）评估患者的临床预后情况；采用O'Kelly-Marotta（OKM）分级评估影像学随访中的动脉瘤闭塞情况。

共纳入14例（14个动脉瘤）接受FD治疗的未破裂LBTAs患者，手术成功率为100%。平均动脉瘤最大径为（18.0±8.9） mm。所有患者均采用单纯FD置入治疗，均未结合弹簧圈栓塞。共使用20枚支架治疗14个动脉瘤，其中2例患者采用3枚支架重叠置入，2例患者采用2枚支架重叠置入。术后共5例（35.7%）患者出现神经系统并发症，其中4例（28.6%）并发症于围手术期首次出现，1例（7.1%）于随访期间出现首次出现。共3例患者死亡，死亡率为21.4%。5例并发症患者首次出现均为缺血性并发症，其中2例（14.3%）患者合并出血性并发症。所有患者末次临床平均随访时间为（25.5±12.3）个月。患者出院及末次随访良好预后（mRS评分>2分）率分别为85.7%（12/14）和71.4%（10/14）。9例患者获得影像学随访，中位随访时间为6（6，8）个月，其中5例（55.5%）患者随访时动脉瘤完全闭塞（OKM分级D级）。

单纯采用FD置入治疗未破裂LBTAs手术成功率高，安全及有效性可。然而，临床医师仍应警惕术后致死或致残性缺血性并发症的发生。

To investigate the safety and efficacy of treatment with standalone flow diverter (FD) placement for unruptured large basilar trunk aneurysms (LBTAs).

Patients with unruptured LBTAs (maximum diameter ≥ 10 mm) who underwent standalone FD placement in the First Hospital of Harbin Medical University from January 2015 to August 2023 were retrospectively included. The occurrence of postoperative complications and follow-up imaging results were evaluated. The modified Rankin Scale (mRS) score was used to assess the clinical outcomes of patients; the O'Kelly-Marotta (OKM) grading was used to evaluate the aneurysm occlusion status during imaging follow-up.

A total of 14 patients (14 aneurysms) with unruptured LBTAs who received FD treatment were included, with a surgical success rate of 100%. The average maximum diameter of the aneurysms was 18.0±8.9 mm. All patients were treated with standalone FD placement without coil embolization. A total of 20 stents were used to treat 14 aneurysms, among which 3 stents were overlappingly placed in 2 patients and 2 stents were overlappingly placed in another 2 patients. Postoperatively, neurological complications occurred in 5 patients (35.7%), of which 4 (28.6%) first appeared during the perioperative period and 1 (7.1%) first appeared during the follow-up period. A total of 3 patients died, with a mortality rate of 21.4%. The first appearance of complications in all 5 patients with complications was ischemic complications, and 2 (14.3%) patients had combined hemorrhagic complications. The average last clinical follow-up time for all patients was 25.5±12.3 months. The rates of favorable outcome (mRS score > 2) at discharge and the last follow-up were 85.7% (12/14) and 71.4% (10/14), respectively. Imaging follow-up was obtained in 9 patients, with a median follow-up time of 6 (6, 8) months, and among them, 5 patients (55.5%) had complete aneurysm occlusion (OKM grade D) during follow-up.

The treatment of unruptured LBTAs with standalone FD placement has a high surgical success rate and acceptable safety and efficacy. However, clinicians should still be vigilant against the occurrence of fatal or disabling ischemic complications after surgery.