Neurosurgical management of aneurysms of the vertebrobasilar system: increasing indications for endovascular therapy with a continued role for open microneurosurgery

Anthony S. Larson, Tapan Mehta, Andrew W. Grande

Research output: Contribution to journalReview articlepeer-review

Abstract

Aneurysms of the vertebrobasilar system remain among the most challenging subsets of aneurysms to treat with an open surgical approach. Since Charles Drake’s pioneering work in the 1960s, several advances in microsurgical techniques have improved outcomes and feasibility in the open surgical management of these aneurysms. In parallel, the field of endovascular neurosurgery has provided several safe and effective treatment options. Multiple trials have suggested that endovascular therapy for aneurysms of the vertebrobasilar system is superior to open surgical management in most cases. In some instances, however, open surgical management likely represents a more effective and durable option relative to endovascular therapy. Therefore, continued training of future cerebrovascular specialists in open surgery of vertebrobasilar aneurysms remains crucial. With widespread utilization of endovascular techniques, however, proper exposure of trainees to such aneurysms is growing increasingly difficult. In this review, we discuss the recent advances in the endovascular management of vertebrobasilar aneurysms while also emphasizing the continued importance of open microneurosurgery in such cases.

Original languageEnglish (US)
JournalNeurosurgical Review
Early online dateJan 6 2021
DOIs
StateE-pub ahead of print - Jan 6 2021

Bibliographical note

Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature.

Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.

Keywords

  • Aneurysms
  • Microneurosurgery
  • Vertebrobasilar system

PubMed: MeSH publication types

  • Journal Article
  • Review

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