Posterior Circulation Aneurysms

Abstract

Since 1969, 218 aneurysms of the posterior circulation have been operated upon in our department. Of this group, 131 were saccular (size less than 15 mm), 47 were globular (15–25 mm), and 40 were giant aneurysms (greater than 25 mm). Aneurysms were seen at all the usual sites. Timing of operation was determined by the patient’s clinical condition and there was a trend toward operation after the 1st week following subarachnoid hemorrhage. All saccular and globular aneurysms were treated by direct clipping. Most of the giant aneurysms could be directly clipped, often only with the use of a “booster” clip. Those giant aneurysms which could not be directly clipped were treated by proximal ligation of the parent artery with or without bypass. The overall results show 165 of 218 patients (75.6%) having an excellent or good outcome; 20 patients (9.2%) had a poor outcome from their illness and/or treatment; 33 patients (15.2%) died. The results are discussed with respect to aneurysm location, aneurysm size, patient preoperative grade, and timing of surgery.