Introduction Vertebrobasilar artery dolichoectatic aneurysms (VBADA) are an expansion of arterial tissue as aneurysmatic formation without obvious neck. Its natural history is poorly known, usually patients are admitted with thromboembolic complications and/or mass effects. There have not been international collective data and correct timing for highly risky treatments has been under discussion.
Objective To define natural history of VBADA by long-term follow-up in international VBADA population.
Material and Methods We collected 370 VBADAs patients from ten centers from Europe, USA, and Japan. The patients were followed until development of new ischemic or hemorrhagic stroke, brainstem or cranial nerve compression, or drop of modified Rankin scale. 183 patients were treated conservatively in first phase of treatment. The needed data for natural history calculations were available for 174 patients with cumulative follow-up of 582,8 patient-years. Multiple statistical analysis were performed to identify annual risk of disease progression.
Results The annual mortality or morbidity was 19,8%. Majority of VBADA patients were male (109) where disease progression was most malignant. Basilar artery location was associated with severe disease progression with annual adverse event of 24,3%. VBADA maximum diameter was directly proportional to the adverse events. Age above 55,5 years predicted mortality.
Conclusion This study verifies malignancy of VBADA and encourage invasive treatment in early phase of disease progression based on radiological characteristics, age and sex of the patients when treatment option is seen suitable.
Disclosures B. Rezai Jahromi: None. N. Ota: None. V. Srinivasan: None. S. Henriksson: None. R. Dashti: None. C. Schwartz: None. J. Jääskeläinen: None. A. Lindgren: None. T. Koivisto: None. B. Jahromi: None. K. Noda: None. M. Potts: None. R. Tanikawa: None. Y. Kalani: None. P. Vajkoczy: None. R. Spetzler: None. F. Göhre: None. J. Hernesniemi: None. M. Lawton: None. M. Niemelä: None.
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