Background: Giant vertebrobasilar aneurysms (GVBAs) have an unfavorable natural history if left untreated and often pose a sizeable challenge to endovascular treatment. The aim of this study was to analyze the angiographic and clinical outcomes of GVBAs treated by various endovascular procedures. Methods: Between January 2010 and September 2018, 27 patients with 27 GVBAs treated endovascularly were enrolled in this consecutive study. The clinical and angiographic features, treatment modalities, and outcomes were analyzed. Results: The patient cohort comprised 21 men (77.8%) and 6 women (22.2%) of mean age 42.7 ± 18.9 years (range, 6-65 years). The most common presenting symptom was compressive symptoms, present in 15 patients (55.6%). None of the GVBAs was ruptured. Of the 27 GVBAs, 23 aneurysms were dissecting aneurysm with intramural hematoma and 4 aneurysms were saccular. Regarding treatment approach, internal trapping was used in 5 aneurysms, stent-assisted coil embolization in 10, sole stenting in 4, and flow diverters in 8. Overall, 12 patients (44.4%) had an unfavorable angiographic or clinical outcome: 3 patients presented with post-operative complications and subsequent death, and 9 with poor prognosis during follow-up. Conclusions: Patients with GVBAs may not benefit from endovascular treatment. Newer-generation devices are necessary to provide more optimal therapy for the management of these complex lesions.

中文翻译：

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与巨大椎基底动脉瘤的血管内治疗有关的不利结果。

背景：如果不及时治疗，巨大椎基底动脉瘤（GVBAs）的自然病程不利，并且常常对血管内治疗构成很大挑战。这项研究的目的是分析通过各种血管内手术治疗的GVBA的血管造影和临床结果。方法：在2010年1月至2018年9月之间，该连续研究纳入了27例接受血管内治疗的27例GVBA的患者。分析了临床和血管造影特征，治疗方式和结局。结果：该患者队列包括21位男性（77.8％）和6位女性（22.2％），平均年龄42.7±18.9岁（范围6-65岁）。最常见的症状是压迫症状，出现在15例患者中（55.6％）。GVBA均未破裂。在27个GVBA中，壁内血肿夹层动脉瘤23例，囊状动脉瘤4例。关于治疗方法，在5例动脉瘤中使用了内部诱捕，在10例中使用了支架辅助线圈栓塞，在4例中使用了单独支架置入术，在8例中使用了分流器。总体而言，有12例（44.4％）患者的血管造影或临床结果不良：3例患者术后并发症和随后的死亡，9随访期间预后不良。结论：GVBAs患者可能无法从血管内治疗中受益。为了为这些复杂病变的治疗提供更理想的治疗方法，新一代设备必不可少。4％）的血管造影或临床结果不良：3例术后并发症并随后死亡，9例在随访中预后不良。结论：GVBAs患者可能无法从血管内治疗中受益。为了为这些复杂病变的治疗提供更理想的治疗方法，新一代设备必不可少。4％的患者血管造影或临床结局不良：3例术后并发症并随后死亡，9例随访期间预后不良。结论：GVBAs患者可能无法从血管内治疗中受益。为了为这些复杂病变的治疗提供更理想的治疗方法，新一代设备必不可少。