Short-term results of surgical treatment of patients with intracranial saccular aneurysms of vertebral artery

The aim of the investigation is to improve the treatment results of patients with aneurysms of vertebral artery (VA) by improving surgical approach. Materials and methods. There were analyzed the operations of 23 patients with saccular aneurysms of the vertebral artery. The age of the patients varied from 30 to 67 years; there were 7 male, and 16 female patients. Aneurysms of the vertebral artery trunk (atVA) were detected in 16 patients, distal aneurysm of posterior inferior cerebellar artery (DaPICA) - in 7. 15 patients were operated in an acute period of hemorrhage, and 8 patients - with the subacute hemorrhage and intact aneurysms. The severity of the patients' state was evaluated according to Hunt-Hess scale on the day of surgery, the treatment results - according to Glasgow outcomes scale (GOS) on the 30th postoperative day. Results. An individual approach was used when choosing the treatment modality. Microsurgical treatment was preferred in DaPICA, and endovascular treatment - for patients with atVA. There were performed 11 open and 12 endovascular operations, ventriculoperitoneal shunting in 6 cases. The severity of the patients' state corresponded to 0 according to Hunt-Hess scale in 5 patients, the I degree - in 3, II - in 1, III - in 7, IV - in 5, V - in 2 cases. Excellent and good results (GOS I and II) were observed in 20 patients out of 23 (87%). Adverse outcomes (GOS III and IV) - in 2 patients, and lethal outcome - in 1 case (13%). The complications directly related to the surgical treatment were in 4 patients (17%). In 85% of cases no statistically significant differences were found comparing short-term and long-term results of treatment. Conclusion. Patients with VA aneurysms have a favorable prognosis in case of an individual approach to the surgical treatment strategy. The assessment of short-term treatment results is an important prognostics factor determining long-term functional outcomes of surgical treatment.