Endovascular treatment of giant vertebrobasilar aneurysms

Giant vertebrobasilar aneurysms (GVBAs) are rare and associated with a poor prognosis if left untreated. These lesions are treacherous once they become symptomatic, with 80% of patients being dead or disabled within 5 years without intervention (1–6). Despite major advances in endovascular options and microneurosurgical techniques, the management of this remarkable subgroup of patients remains challenging. These complex cases and the present chapter illustrate the necessary adjustment of the therapeutic strategy to the individual situation with regard to the disease but also to the anatomy for the purpose of anticipated collateral circulation.