{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T05:05:06Z","timestamp":1789621506647,"version":"build-2803163510"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Ruptured basilar artery dissecting aneurysms (BADAs) are rare and associated with high risks of rebleeding, brainstem ischemia, and death. Evidence specific to the basilar artery remains limited, and experience derived from vertebral artery dissections may not be directly transferable because the basilar trunk supplies numerous critical pontine perforators and generally cannot be sacrificed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To describe the real-world management of a consecutive cohort of ruptured BADA and compare long-term clinical outcomes after primary flow diverter (FD)-based versus conventional endovascular treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective single-center cohort study included consecutive patients with angiographically confirmed ruptured BADA who underwent endovascular treatment between February 2015 and April 2024. Patients were classified according to the index endovascular treatment as the FD group or the conventional endovascular treatment group. The primary outcome was favorable functional outcome (mRS 0\u20132) at the last follow-up. Secondary outcomes included mortality, retreatment, complications, and descriptive radiological outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty-two patients were included: 5 received FD-based treatment as the index strategy and 17 received conventional endovascular treatment. Fusiform morphology was more frequent in the FD group (80.0% vs. 23.5%,\n                      <jats:italic>p<\/jats:italic>\n                      =\u202f0.039), while aneurysm maximum diameter was numerically larger (median 19.0 vs. 6.0\u202fmm,\n                      <jats:italic>p<\/jats:italic>\n                      =\u202f0.078). At the last follow-up, 4 of 5 patients (80.0%) in the FD group and 9 of 17 patients (52.9%) in the conventional group had a favorable outcome (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.360). Mortality was 20.0 and 47.1%, respectively (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.360).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Primary FD-based reconstruction was feasible in selected ruptured BADA, particularly in anatomically complex or fusiform lesions. Given the small sample, non-randomized treatment selection, and absence of statistically significant between-group differences, these findings support individualized treatment and do not establish superiority of either strategy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1940068","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T04:49:44Z","timestamp":1789620584000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Flow diversion versus conventional endovascular treatment for ruptured basilar artery dissecting aneurysms: a single-center cohort study"],"prefix":"10.3389","volume":"17","author":[{"given":"Bowen","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Zhengzhou University People\u2019s Hospital, Henan Provincial People\u2019s Hospital","place":["Zhengzhou, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Zhengzhou University People\u2019s Hospital, Henan Provincial People\u2019s Hospital","place":["Zhengzhou, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiangyu","family":"Xue","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Zhengzhou University People\u2019s Hospital, Henan Provincial People\u2019s Hospital","place":["Zhengzhou, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gangqin","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Zhengzhou University People\u2019s Hospital, Henan Provincial People\u2019s Hospital","place":["Zhengzhou, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tongyuan","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Zhengzhou University People\u2019s Hospital, Henan Provincial People\u2019s Hospital","place":["Zhengzhou, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongyang","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Zhengzhou University People\u2019s Hospital, Henan Provincial People\u2019s Hospital","place":["Zhengzhou, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongcan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Zhengzhou University People\u2019s Hospital, Henan Provincial People\u2019s Hospital","place":["Zhengzhou, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingkun","family":"He","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Zhengzhou University People\u2019s Hospital, Henan Provincial People\u2019s Hospital","place":["Zhengzhou, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanyan","family":"He","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Zhengzhou University People\u2019s Hospital, Henan Provincial People\u2019s Hospital","place":["Zhengzhou, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sijin","family":"Yang","sequence":"additional","affiliation":[{"name":"School of Computer and Artificial Intelligence, Zhengzhou University","place":["Zhengzhou, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianxiao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Zhengzhou University People\u2019s Hospital, Henan Provincial People\u2019s Hospital","place":["Zhengzhou, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"3427","DOI":"10.1007\/s10143-022-01857-6","article-title":"The optimal management of ruptured basilar artery dissecting aneurysms: a case series and scoping review","volume":"45","author":"Oya","year":"2022","journal-title":"Neurosurg Rev"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1937","DOI":"10.3174\/ajnr.A1243","article-title":"Management and clinical outcome of acute basilar artery dissection","volume":"29","author":"Kim","year":"2008","journal-title":"AJNR Am J Neuroradiol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1159\/000319069","article-title":"Basilar artery dissection: series of 12 consecutive cases and review of the literature","volume":"30","author":"Ruecker","year":"2010","journal-title":"Cerebrovasc Dis"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"676.e1","DOI":"10.1016\/j.wneu.2016.04.107","article-title":"Three cases of ruptured basilar artery dissection: from diagnosis to endovascular treatment","volume":"91","author":"Derelle","year":"2016","journal-title":"World Neurosurg"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1194","DOI":"10.1136\/jnis-2022-019864","article-title":"Reconstructive endovascular treatment for basilar artery trunk aneurysms: complications and clinical and angiography outcomes","volume":"15","author":"Zhong","year":"2023","journal-title":"J Neurointerv Surg"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1628676","DOI":"10.3389\/fneur.2025.1628676","article-title":"Complications and long-term outcomes after endovascular treatment of basilar trunk aneurysms","volume":"16","author":"Bi","year":"2025","journal-title":"Front Neurol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"885776","DOI":"10.3389\/fneur.2022.885776","article-title":"Reconstructive endovascular treatment of basilar trunk and vertebrobasilar junction aneurysms: a review of 77 consecutive cases","volume":"13","author":"Peng","year":"2022","journal-title":"Front Neurol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1225","DOI":"10.3174\/ajnr.A3166","article-title":"Safety of the pipeline embolization device in treatment of posterior circulation aneurysms","volume":"33","author":"Phillips","year":"2012","journal-title":"AJNR Am J Neuroradiol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1093\/neuros\/nyaa317","article-title":"Giant fusiform and dolichoectatic aneurysms of the basilar trunk and vertebrobasilar junction: clinicopathological and surgical outcome","volume":"88","author":"Nakatomi","year":"2021","journal-title":"Neurosurgery"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"2425","DOI":"10.1161\/STROKEAHA.111.617381","article-title":"Incidence and risk factors of recurrence after endovascular treatment of intracranial vertebrobasilar dissecting aneurysms","volume":"42","author":"Kim","year":"2011","journal-title":"Stroke"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"801","DOI":"10.3348\/kjr.2016.17.5.801","article-title":"Stent-assisted coil embolization of vertebrobasilar dissecting aneurysms: procedural outcomes and factors for recanalization","volume":"17","author":"Jeon","year":"2016","journal-title":"Korean J Radiol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"793","DOI":"10.1002\/ana.25484","article-title":"Flow diversion for treatment of intracranial aneurysms: mechanism and implications","volume":"85","author":"Chua","year":"2019","journal-title":"Ann Neurol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"e164","DOI":"10.1016\/j.wneu.2017.09.125","article-title":"Endovascular treatment of ruptured vertebrobasilar dissecting aneurysms using flow diversion embolization devices: single-institution experience","volume":"109","author":"Guerrero","year":"2018","journal-title":"World Neurosurg"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"111","DOI":"10.3171\/2015.6.JNS1565","article-title":"The safety of pipeline flow diversion in fusiform vertebrobasilar aneurysms: a consecutive case series with longer-term follow-up from a single US center","volume":"125","author":"Natarajan","year":"2016","journal-title":"J Neurosurg"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1258","DOI":"10.3171\/2012.2.JNS111942","article-title":"Panacea or problem: flow diverters in the treatment of symptomatic large or giant fusiform vertebrobasilar aneurysms","volume":"116","author":"Siddiqui","year":"2012","journal-title":"J Neurosurg"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"937","DOI":"10.3171\/2013.5.JNS122494","article-title":"Risk of hemorrhagic complication associated with ventriculoperitoneal shunt placement in aneurysmal subarachnoid hemorrhage patients on dual antiplatelet therapy","volume":"119","author":"Mahaney","year":"2013","journal-title":"J Neurosurg"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"26","DOI":"10.5853\/jos.2023.02481","article-title":"Emerging concept of intracranial arterial diseases: the role of high resolution vessel wall MRI","volume":"26","author":"Kang","year":"2024","journal-title":"J Stroke"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1444","DOI":"10.1016\/j.jstrokecerebrovasdis.2016.01.047","article-title":"Evaluation of the arterial wall in vertebrobasilar artery dissection using high-resolution magnetic resonance vessel wall imaging","volume":"25","author":"Arai","year":"2016","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"106302","DOI":"10.1016\/j.jstrokecerebrovasdis.2021.106302","article-title":"Structural changes of intra- and extracranial artery dissection: a study of high-resolution magnetic resonance imaging","volume":"31","author":"Kwon","year":"2022","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1177\/15910199231193904","article-title":"Complications after endovascular treatment of large basilar trunk aneurysms","volume":"32","author":"Wu","year":"2026","journal-title":"Interv Neuroradiol"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1136\/neurintsurg-2013-010793","article-title":"Non-saccular vertebrobasilar aneurysms and dolichoectasia: a systematic literature review","volume":"6","author":"Shapiro","year":"2014","journal-title":"J Neurointerv Surg"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1227\/NEU.0000000000000579","article-title":"Use of coils in conjunction with the pipeline embolization device for treatment of intracranial aneurysms","volume":"76","author":"Lin","year":"2015","journal-title":"Neurosurgery"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"25153","DOI":"10.1038\/s41598-025-11035-5","article-title":"LEO or LEO baby within Enterprise overlapping stents combined with coil embolization treatment for ruptured vertebrobasilar artery dissecting aneurysms","volume":"15","author":"Wu","year":"2025","journal-title":"Sci Rep"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1940068\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T04:49:51Z","timestamp":1789620591000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1940068\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,17]]},"references-count":23,"alternative-id":["10.3389\/fneur.2026.1940068"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2026.1940068","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,17]]},"article-number":"1940068"}}