Treatment of dissecting basilar artery aneurysm by flow reversal

Acta Neurochir (Wien). 1997;139(1):44-51. doi: 10.1007/BF01850867.

Abstract

Dissecting aneurysm of the basilar artery is a rare but increasingly recognized entity, with a frequently fatal or morbid outcome. Unlike the well established proximal occlusion and trapping approaches to vertebral artery dissections, surgical intervention for basilar lesions has been limited to wrapping techniques for arterial wall reinforcement. We report a case of midbasilar dissecting aneurysm successfully treated by clipping the proximal basilar artery below the level of the anterior inferior cerebellar arteries, allowing retrograde flow via the posterior communicating arteries to provide continued basilar perfusion. With the growing recognition of basilar dissection and pseudoaneurysm formation there is a need for improved therapeutic options. We suggest that definitive treatment can be achieved using the principle of proximal occlusion and flow reversal, and review the pertinent literature on basilar artery dissection.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aneurysm, Dissecting / diagnostic imaging
  • Aneurysm, Dissecting / surgery*
  • Arteries / surgery
  • Basilar Artery / diagnostic imaging
  • Basilar Artery / surgery*
  • Brain / blood supply*
  • Cerebellum / blood supply
  • Female
  • Humans
  • Intracranial Aneurysm / diagnostic imaging
  • Intracranial Aneurysm / surgery*
  • Middle Aged
  • Postoperative Complications / diagnostic imaging
  • Radiography
  • Regional Blood Flow
  • Subarachnoid Hemorrhage / diagnostic imaging
  • Subarachnoid Hemorrhage / surgery*