The site of the Media Sphera Publishers contains materials intended solely for healthcare professionals.
By closing this message, you confirm that you are a certified medical professional or a student of a medical educational institution.

Login
EN
+7 (495) 482-4118
+7 (495) 482-0604
+8 800 250-18-12
  • (toll-free number for subscriptions)
    Mon-Fri from 10 a.m. to 6 p.m.

  • © 1998-2025
+7 (495) 482-43-29
EN
All journals
Journal
Year
Year
Search result: 0

Kheyreddin A.S.

Burdenko Neurosurgery Center

Kaftanov A.N.

Burdenko Neurosurgical Center

Yakovlev S.B.

Burdenko National Medical Research Center of Neurosurgery

Eliava Sh.Sh.

Burdenko Neurosurgical Center

Arustamyan S.R.

Burdenko National Medical Research Center of Neurosurgery

Mikeladze K.G.

Burdenko National Medical Research Center of Neurosurgery

Surgical treatment of vertebral artery confluence aneurysms

Authors:

Kheyreddin A.S., Kaftanov A.N., Yakovlev S.B., Eliava Sh.Sh., Arustamyan S.R., Mikeladze K.G.

More about the authors

Journal: Burdenko's Journal of Neurosurgery. 2021;85(3): 45‑52

DOI: 10.17116/neiro20218503145

Read: 3826 times

Download PDF (RU)
Download PDF
Contact the author
Table of contents

SURGICAL TREATMENT OF VERTEBRAL ARTERY CONFLUENCE ANEURYSMS
SURGICAL TREATMENT OF VERTEBRAL ARTERY CONFLUENCE ANEURYSMS

To cite this article:

Kheyreddin AS, Kaftanov AN, Yakovlev SB, Eliava ShSh, Arustamyan SR, Mikeladze KG. Surgical treatment of vertebral artery confluence aneurysms. Burdenko's Journal of Neurosurgery. 2021;85(3):45‑52. (In Russ., In Engl.)
https://doi.org/10.17116/neiro20218503145

Подписка 2025 Журнал «Вопросы нейрохирургии» имени Н.Н. Бурденко (Burdenko's Journal of Neurosurgery)
 
МСФ на ЯМ
Использование инфографики авторами научных работ
Close metadata
Recommended articles:
Surgical treatment of ecce­ntric-fusiform aneurysm of proximal basi­lar artery. Case report and lite­rature review. Burdenko's Journal of Neurosurgery. 2025;(3):92-99
Abstract:

BACKGROUND

Aneurysms of vertebral artery confluence and proximal parts of basilar artery are extremely rare. They are usually combined with proximal fenestration of basilar artery. No timely surgical treatment of these aneurysms is associated with high risk of adverse outcomes, and their treatment is a challenge for neurosurgeons.

MATERIAL AND METHODS

We analyzed postoperative outcomes in 17 patients with 21 aneurysms of vertebral artery confluence and proximal parts of basilar artery.

RESULTS

Six patients with 10 aneurysms underwent microsurgical resection, 11 patients with 11 aneurysms — endovascular procedure. Persistent postoperative deterioration was observed in 5 (29.4%) patients: severe neurological symptoms (GOS grade 3) in 1 case (5.9%), minor bulbar disorders in 4 cases (23.53%). There were no lethal outcomes.

CONCLUSION

According to our own and literature data, aneurysms of vertebral artery confluence are extremely rare. The risk of rupture of these aneurysms is extremely high. Endovascular approach is preferred in these patients. Microsurgical procedure is an acceptable alternative if endovascular surgery is impossible.

Keywords:

aneurysms
SAH
aneurysms of vertebral artery confluence
aneurysms of proximal basilar artery
basilar artery fenestration
aneurysms of rare localizations

Authors:

Kheyreddin A.S.

Burdenko Neurosurgery Center

Kaftanov A.N.

Burdenko Neurosurgical Center

Yakovlev S.B.

Burdenko National Medical Research Center of Neurosurgery

Eliava Sh.Sh.

Burdenko Neurosurgical Center

Arustamyan S.R.

Burdenko National Medical Research Center of Neurosurgery

Mikeladze K.G.

Burdenko National Medical Research Center of Neurosurgery

Received:

30.05.2020

Accepted:

19.03.2021

Close metadata

References:

  1. Trivelato FP, Abud DG, Nakiri GS, de Castro Afonso LH, Ulhôa AC, Manzato LB, Rezende MT. Basilar Artery Fenestration Aneurysms: Endovascular Treatment Strategies Based on 3D Morphology. Clinical Neuroradiology. 2016;26(1):73-79.  https://doi.org/10.1007/s00062-014-0336-0
  2. Cooke DL, Stout CE, Kim WT, Kansagra AP, Yu JP, Gu A, Jewell NP, Hetts SW, Higashida RT, Dowd CF, Halbach VV. Cerebral arterial fenestrations. Interventional Neuroradiology. 2014;20(3):261-274.  https://doi.org/10.15274/INR-2014-10027
  3. Alqahtani SA, Felbaum DR, Tai A, Liu AH, Armonda RA. Endovascular Treatment of Large Unruptured Fusiform Fenestrated Vertebrobasilar Junction Aneurysm. Cureus. 2017;9(5):e1219. https://doi.org/10.7759/cureus.1219
  4. Tanaka S, Tokimura H, Makiuchi T, Nagayama T, Takasaki K, Tomosugi T, Hirahara K, Yamahata H, Campos F, Nishizawa T, Arita K. Clinical presentation and treatment of aneurysms associated with basilar artery fenestration. Journal of Clinical Neuroscience. 2012;19(3):394-401.  https://doi.org/10.1016/j.jocn.2011.04.043
  5. Albanese E, Russo A, Ulm AJ. Fenestrated vertebrobasilar junction aneurysm: diagnostic and therapeutic considerations. Journal of Neurosurgery. 2009;110(3):525-529.  https://doi.org/10.3171/2008.9.JNS08170
  6. Rajwani KM, Koumellis P, Bucur S. Unusual and complex vertebrobasilar artery aneurysm. BMJ Case Reports. 2014;2014:bcr2014205625. https://doi.org/10.1136/bcr-2014-205625
  7. Shi X, Qian H, Singh KC, Zhang Y, Zhou Z, Sun Y, Liu F. Surgical management of vertebral and basilar artery aneurysms: a single center experience in 41 patients. Acta Neurochirurgica. 2013;155(6):1087-1093. https://doi.org/10.1007/s00701-013-1656-6
  8. Peluso JP, van Rooij WJ, Sluzewski M, Beute GN. Aneurysms of the vertebrobasilar junction: incidence, clinical presentation, and outcome of endovascular treatment. AJNR. American Journal of Neuroradiology. 2007;28(9): 1747-1751. https://doi.org/10.3174/ajnr.A0654
  9. Graziano F, Ganau M, Iacopino DG, Boccardi E. Vertebro-basilar junction aneurysms: a single centre experience and meta-analysis of endovascular treatments. The Neuroradiology Journal. 2014;27(6):732-741.  https://doi.org/10.15274/NRJ-2014-10100
  10. Sogawa K, Kikuchi Y, O’uchi T, Tanaka M, Inoue T. Fenestrations of the basilar artery demonstrated on magnetic resonance angiograms: an analysis of 212 cases. Interventional Neuroradiology. 2013;19(4):461-465.  https://doi.org/10.1177/159101991301900409
  11. Sanders WP, Sorek PA, Mehta BA. Fenestration of intracranial arteries with special attention to associated aneurysms and other anomalies. AJNR. American Journal of Neuroradiology. 1993;14(3):675-680. 
  12. Arráez-Aybar LA, Villar-Martin A, Poyatos-Ruiperez C, Rodriguez-Boto G, Arrazola-Garcia J. Prevalence of fenestrated basilar artery with magnetic resonance angiography: a transversal study. Surgical and Radiologic Anatomy: SRA. 2013;35(6):487-493.  https://doi.org/10.1007/s00276-012-1053-5
  13. Grand W, Budny JL, Gibbons KJ, Sternau LL, Hopkins LN. Microvascular surgical anatomy of the vertebrobasilar junction. Neurosurgery. 1997; 40(6):1219-1225. https://doi.org/10.1097/00006123-199706000-00021
  14. Sanai N, Tarapore P, Lee AC, Lawton MT. The current role of microsurgery for posterior circulation aneurysms: a selective approach in the endovascular era. Neurosurgery. 2008;62(6):1236-1253. https://doi.org/10.1227/01.neu.0000333295.59738.de
  15. Itami H, Sugiu K, Hiramatsu M, Tokunaga K, Haruma J, Okuma Y, Hishikawa T, Nishida A, Date I. Endovascular treatment of basilar artery aneurysms associated with fenestration. Neurological Surgery. 2013;41(7):583-592. 
  16. Choo YS, Lee CY. Kissing Aneurysms at Fenestrated Proximal Basilar Artery: Double-barrel Stent-assisted Coiling Using Dual Closed-cell Stents. Journal of Cerebrovascular and Endovascular Neurosurgery. 2017;19(2):120-124.  https://doi.org/10.7461/jcen.2017.19.2.120
  17. Sen CN, Sekhar LN. Extreme lateral transcondylar and transjugular approaches. In: Sekhar LN, Janecka IP: Surgery of Cranial Base Tumors. New York: Raven Press; 1993. https://doi.org/10.1016/S0266-4356(97)90677-X
  18. Bertalanffy H, Seeger W. The dorsolateral, suboccipital, transcondylar approach to the lower clivus and anterior portion of the craniocervical junction. Neurosurgery. 1991;29(6):815-821.  https://doi.org/10.1097/00006123-199112000-00002
  19. Heros RC. Lateral suboccipital approach for vertebral and vertebrobasilar artery lesions. Journal of Neurosurgery. 1986;64(4):559-562.  https://doi.org/10.3171/jns.1986.64.4.0559
  20. Rohde V, Schaller C, Hassler W. The extreme lateral transcondylar approach to aneurysms of the vertebrobasilar junction, the vertebral artery, and the posterior inferior cerebellar artery. Skull Base Surgery. 1994;4(4):177-180.  https://doi.org/10.1055/s-2008-1058952
  21. Seifert V. Direct surgery of basilar trunk and vertebrobasilar junction aneurysms via the combined transpetrosal approach. Neurologia Medico-Chirurgica. 1998;38(suppl):86-92.  https://doi.org/10.2176/nmc.38.suppl_86
Contact the author
Email
Message
The publishing house "Media Sphere" does not provide treatment services, does not give recommendations on contacting medical institutions and specific specialists, on the prescription of medicines and dietary supplements.

Email Confirmation

An email was sent to test@gmail.com with a confirmation link. Follow the link from the letter to complete the registration on the site.

Email Confirmation

Contact us
If you have any questions, complaints or suggestions, please use this feedback form.
Email
Message
The publishing house "Media Sphere" does not provide treatment services, does not give recommendations on contacting medical institutions and specific specialists, on the prescription of medicines and dietary supplements.
Submit Application

You can become an author of one of our magazines, send a request and we will consider it in during the day.

Name
Phone
E-mail
Message
Login
Registration
E-mail
Password
Forgot Password?

Log in to the site using your account in one of the services

Password recovery
E-mail
Login
Register

We use cооkies to improve the performance of the site. By staying on our site, you agree to the terms of use of cооkies. To view our Privacy and Cookie Policy, please. click here.