Safety and Efficacy of Endovascular Therapy for Basilar Artery Trunk Aneurysms: Single-Center Experience

doi:10.3877/cma.j.issn.2095-5782.2026.01.005

Abstract

Abstract:

Objective

The optimal treatment strategy for basilar artery trunk aneurysms (BATA) remains controversial. This study aimed to evaluate the safety and efficacy of endovascular treatment for BATA.

Methods

A retrospective analysis was performed on 40 BATA patients (41 aneurysms in total) who underwent endovascular treatment in our institute between October 2018 and December 2024. Based on digital subtraction angiography (DSA) findings, aneurysms were categorized into saccular, classic, segmental dilatation, and dolichoestasia types. Perioperative cerebrovascular complications were recorded. Immediate and 6-month embolization degrees were assessed with the Raymond scale, while clinical outcomes were evaluated with modified Rankin Scale (mRS) scores at 3-month follow-up.

Results

Among the 41 aneurysms, 9 were saccular (22.0%), 18 classic (43.9%), 5 segmental dilatation (12.2%), and 9 dolichoestasia (22.0%). All aneurysms were successfully treated with stent-assisted coiling (SAC), including single-stent SAC in 11 cases (27.5%), overlapping-stent SAC in 26 cases (65.0%), and flow diverters in 3 cases (7.5%). Immediate postprocedural Raymond grades were Ⅰ in 13 (31.7%), Ⅱ in 16 (39.0%), and Ⅲ in 12 (29.3%) cases. Perioperative complications included: 1 (2.5%) intraoperative re-rupture of classic dissecting aneurysm, 1 (2.5%) acute stent thrombosis in dolichoestasia aneurysm (no improvement after tirofiban infusion). Postprocedurally acute ischemic events occurred in 1 saccular aneurysm case (2.5%), and the patient was left with left-sided hemiplegia at discharge. Two dolichoestasia cases (5.0%) developed acute ischemic events after the procedure but showed no significant disability at discharge (mRS: 2). At 3-month follow-up, 33 patients (82.5%) achieved favorable outcomes (mRS 0-2). Among 31 cases with 6-month DSA follow-up, 24 (77.4%) achieved complete occlusion (Raymond I).

Conclusion

For saccular and classic dissecting BATAs, conventional stent-assisted coiling is technically feasible and safe, with a high occlusion rate and an acceptable recurrence rate. Despite the occurrence of periprocedural ischemic events, overlapping large woven stents techniques and flow diverters can further improve treatment outcomes for segmental dilatation and dolichoestasia aneurysms.

Key words: intracranial aneurysm, basilar artery, dissecting, dolichoestasia, endovascular treatment

Haibin Chen, Linbo Zhao, Sheng Liu. Safety and Efficacy of Endovascular Therapy for Basilar Artery Trunk Aneurysms: Single-Center Experience[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2026, 14(01): 33-39.

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URL: https://zhjrfsxdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-5782.2026.01.005

https://zhjrfsxdzzz.cma-cmc.com.cn/EN/Y2026/V14/I01/33

Figures/Tables 7

项目	患者（n=40）
年龄[岁, $x ¯$ ±s]	67.9±10.3
性别[例(%)]
女性	12 (30.0)
男性	28 (70.0)
高血压[例(%)]	35 (87.5)
糖尿病[例(%)]	7 (17.5)
吸烟[例(%)]	7 (17.5)
破裂动脉瘤[例(%)]	4 (10.0)
动脉瘤类型[例(%)]
囊状	9 (22.0)
经典型	18 (43.9)
节段扩张型	5 (12.2)
延长扩张型	9 (22.0)
动脉瘤最大径(mm, $x ¯$ ±s)	13.3±11.7
治疗方式[例(%)]
单支架	11 (27.5)
重叠支架	26 (65.0)
血流导向装置	3 (7.5)
围手术期脑血管并发症[例(%)]
出血事件	1 (2.5)
缺血事件	4 (10.0)

项目	患者（n=40）
年龄[岁, $x ¯$ ±s]	67.9±10.3
性别[例(%)]
女性	12 (30.0)
男性	28 (70.0)
高血压[例(%)]	35 (87.5)
糖尿病[例(%)]	7 (17.5)
吸烟[例(%)]	7 (17.5)
破裂动脉瘤[例(%)]	4 (10.0)
动脉瘤类型[例(%)]
囊状	9 (22.0)
经典型	18 (43.9)
节段扩张型	5 (12.2)
延长扩张型	9 (22.0)
动脉瘤最大径(mm, $x ¯$ ±s)	13.3±11.7
治疗方式[例(%)]
单支架	11 (27.5)
重叠支架	26 (65.0)
血流导向装置	3 (7.5)
围手术期脑血管并发症[例(%)]
出血事件	1 (2.5)
缺血事件	4 (10.0)

结果指标	术后即刻造影结果[n=41，n (%)]			随访6个月造影结果[n=31，n (%)]
结果指标	Raymond Ⅰ级	Raymond Ⅱ级	Raymond Ⅲ级	Raymond Ⅰ级	Raymond Ⅱ级	Raymond Ⅲ级
囊状	6 (14.6)	3 (7.3)	/	4 (12.9)	1 (3.2)	1 (3.2)
经典型	7 (17.1)	8 (19.5)	3 (7.3)	13 (41.9)	1 (3.2)	1 (3.2)
节段扩张型	/	3 (7.3)	2 (4.9)	2 (6.5)	1 (3.2)	/
延长扩张型	/	2 (4.9)	7 (17.1)	5 (16.1)	1 (3.2)	1 (3.2)
合计	13 (31.7)	16 (39.0)	12 (29.3)	24 (77.4)	4 (12.9)	3 (9.7)

mRS评分	囊状	经典型	节段扩张型	延长扩张型	共计
0~2	9	15	4	5	33
3~5	/	1	1	3	5
6	/	1	/	1	2

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