Posterior Circulation Aneurysms: A Critical Appraisal of a Surgical Series in Endovascular Era

Research output: Chapter in Book/Report/Conference proceedingChapter


The advent of the endovascular era has apparently decreased the role of microneurosurgery for many of the posterior circulation aneurysms. This study consists of a critical appraisal of a retrospective surgical series regarding posterior circulation aneurysms, targeted to define whether microneurosurgery still has a role for some of these. In 28 years, 157 aneurysms were surgically treated, 98 of which ruptured. The Average patient age was 56.7 ± 14.2 years, while in hemorrhagic cases, the mean Hunt-Hess score was 2.17 ± 0.8. Basilar tip, vertebral artery and proximal posterior inferior cerebellar artery were the most frequently involved sites. The treatment consisted of 128 clippings, 19 trappings, 7 wrappings, and 3 bypasses. A total exclusion was achieved in 88.5% of the aneurysms. An average follow-up of 67.1 ± 61.3 months proved no recurrences. The best results were observed in patients <65 years old who harbored small-to-regular aneurysms of the basilar tip, distal cerebellar arteries, or vertebral artery. Clipping proved to be a definitive and durable treatment for a large part of posterior circulation aneurysms, whereas bypass allows for treating aneurysms not amenable for coiling, stenting, or clipping. The present study confirms that microneurosurgery continues to have a paramount role within neurovascular pathology.

Original languageEnglish
Title of host publicationActa Neurochirurgica, Supplementum
PublisherSpringer Science and Business Media Deutschland GmbH
Number of pages7
Publication statusPublished - 2021

Publication series

NameActa Neurochirurgica, Supplementum
ISSN (Print)0065-1419
ISSN (Electronic)2197-8395


  • Basilar artery
  • Brain aneurysms
  • Clipping
  • Far lateral approach
  • Posterior inferior cerebellar artery
  • Vertebral artery

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


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