{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T11:36:54Z","timestamp":1791545814044,"version":"4.3.4"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2020,8,3]],"date-time":"2020-08-03T00:00:00Z","timestamp":1596412800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/ mailto:journals.permissions@oup.com"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurosurg.","NEUROS"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Giant fusiform and dolichoectatic aneurysms of the basilar trunk and vertebrobasilar junction (BTVBJ-GFDA) are extremely difficult to treat.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To evaluate factors influencing survival and outcome of BTVBJ-GFDA by performing a retrospective multicenter cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A total of 32 patients with BTVBJ-GFDA were included in this study. Clinicopathological characteristics, treatment measures, and outcomes were collected from medical records and imaging studies. Autopsy and histological findings of the aneurysm and adjacent brain tissue were also obtained in 9 cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      A total of 11 patients did not undergo surgery, of whom 10 died; 3 from progressive brainstem compression, 4 from subarachnoid hemorrhage, 2 from brainstem infarction, and 1 from associated atherosclerotic disease. The remaining 21 patients underwent a surgical treatment, consisting of immediately proximal parent artery occlusion, remotely proximal parent artery occlusion, clip reconstruction, and distal bypass and achieved significantly longer overall survival compared with those who received conservative therapy (adjusted hazard ratio 1.508, 95% CI 1.058-2.148,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a0.02). Histological examination of the aneurysms demonstrated staged clots, open lumen, and intrathrombotic channels with endothelial lining. The patients younger than 45 yr of age showed statistically longer survival than those equal and older than 45 yr (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a0.03).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Surgical intervention achieved greater survival than conservative management in BTVBJ-GFDA. Narrow ideal treatment window of the blood flow within the aneurysm to maintain sufficient but not excess supply should be targeted based on the hemodynamics of both the posterior communicating arteries and perforating vessel collaterals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/neuros\/nyaa317","type":"journal-article","created":{"date-parts":[[2020,7,13]],"date-time":"2020-07-13T07:28:11Z","timestamp":1594625291000},"page":"82-95","source":"Crossref","is-referenced-by-count":47,"title":["Giant Fusiform and Dolichoectatic Aneurysms of the Basilar Trunk and Vertebrobasilar Junction\u2014Clinicopathological and Surgical Outcome"],"prefix":"10.1227","volume":"88","author":[{"given":"Hirofumi","family":"Nakatomi","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, Japan"},{"name":"Division of Collaborative Laboratory for Medical Science of Neural Dynamics, RIKEN Center for Brain Science, Saitama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Kiyofuji","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideaki","family":"Ono","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minoru","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyasu","family":"Kamiyama","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Stroke, Teishinkai Hospital, Hokkaido, 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Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akio","family":"Morita","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nippon Medical University, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly D","family":"Flemming","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J","family":"Link","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,1]]},"reference":[{"issue":"3","key":"bib1-20231011","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1007\/BF00342416","article-title":"Clinical-angiographic correlations in 132 patients with megadolichovertebrobasilar 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