Surgical treatment of vertebral artery confluence aneurysms

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

Downloaded: 64

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 2025-2 (Burdenko's Journal of Neurosurgery)

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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

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