“Double-Barrel” Stent Reconstruction of a Symptomatic Fusiform Basilar Artery Aneurysm: Case Report

Neurosurgery ◽  
2011 ◽  
Vol 68 (5) ◽  
pp. E1491-E1496 ◽  
Author(s):  
Mark Bain ◽  
Muhammad Shazam Hussain ◽  
Alejandro Spiotta ◽  
Vivekananda Gonugunta ◽  
Shaye Moskowitz ◽  
...  
Keyword(s):  
Basilar Artery ◽  
Cerebral Arteries ◽  
Artery Aneurysm ◽  
High Rate ◽  
Neurologic Recovery ◽  
Aneurysmal Dilation ◽  
Basilar Artery Aneurysm ◽  
Flow Through ◽  
Aneurysm Thrombosis ◽  
Near Occlusion

Abstract BACKGROUND AND IMPORTANCE: Giant fusiform aneurysms of the basilar artery are associated with a high rate of morbidity and mortality. Treatment of these lesions can be difficult, especially when there are poor anatomic collaterals such as posterior communicating arteries. These lesions often have no acceptable treatment. The authors present a case of a patient with a symptomatic, fusiform basilar artery aneurysm successfully treated with a side-by-side (double-barrel), telescoping stent construct. CLINICAL PRESENTATION: A 56-year-old man presented with chief concerns of dysarthria and left-sided hemiparesis. MRI and conventional catheter-based angiography revealed a dolichoectatic basilar artery with 3 large fusiform aneurysms throughout its length. Flow through the patient's aneurysm was successfully reduced with a side-by-side stent construct and coiling of the proximal aneurysm dilation. The patient experienced stabilization of his ischemic events and neurologic recovery. A total of 6 Neurform-2 4.5 × 30-mm stents were navigated and positioned from the proximal posterior cerebral arteries to the distal vertebral arteries in a side-by-side (double-barrel), telescoping manner. These were deployed simultaneously by 2 operators to oppose the stent struts as well as the arterial wall. Next, the proximal aneurysmal dilation was coiled to near occlusion. Successful flow redirection and aneurysm thrombosis was observed. CONCLUSION: A novel, endovascular stenting technique for successfully treating symptomatic, giant basilar artery aneurysms is presented. This patient at 4 months was living independently with no further neurologic events or decline.

Enlargement and Rupture of Distal Basilar Artery Aneurysm after Iatrogenic Carotid Occlusion

Neurosurgery ◽  
1987 ◽  
Vol 20 (4) ◽  
pp. 624-628 ◽  
Author(s):  
Hunt Batjer ◽  
Bruce Mickey ◽  
Duke Samson
Keyword(s):  
Basilar Artery ◽  
Artery Bypass ◽  
Cerebral Arteries ◽  
Bypass Graft ◽  
Artery Aneurysm ◽  
Giant Aneurysm ◽  
Basilar Artery Aneurysm ◽  
Flow Through ◽  
Aggressive Attack ◽  
Temporal Middle

Abstract A case of angiographic enlargement and fatal rupture of a previously asymptomatic distal basilar aneurysm in a 12-year-old girl is reported. She had been treated by carotid sacrifice for a giant intracavernous carotid aneurysm. After superficial temporal-middle cerebral artery bypass, this patient underwent a trapping procedure and decompression of her symptomatic giant aneurysm. Despite postoperative patency of her bypass graft, the involved middle cerebral circulation was irrigated substantially by retrograde flow through her posterior communicating artery. An incidental distal basilar aneurysm involving the origin of her superior cerebellar arteries, posterior cerebral arteries, and multiple perforators was treated by a wrapping procedure. Eleven days after carotid ligation, she suffered a fatal subarachnoid hemorrhage from her basilar aneurysm. This catastrophe was undoubtedly produced by our failure to consider the additional hemodynamic stress placed upon the distal basilar artery by carotid sacrifice and may have been preventable by a more aggressive attack on this previously asymptomatic lesion.

scholarly journals Basilar artery aneurysm thrombosis

Neurology ◽  
2002 ◽  
Vol 59 (8) ◽  
pp. 1287-1287 ◽  
Author(s):  
P. Mandava ◽  
A. Bebensee ◽  
R. R. Rawlings ◽  
T. A. Kent
Keyword(s):  
Basilar Artery ◽  
Artery Aneurysm ◽  
Basilar Artery Aneurysm ◽  
Aneurysm Thrombosis

The First Description of a Basilar Artery Aneurysm Rupture in 1836

2013 ◽  
Vol 74 (S 01) ◽  
Author(s):  
Andreas Demetriades ◽  
Takashi Horiguchi ◽  
James Goodrich ◽  
Takeshi Kawase
Keyword(s):  
Basilar Artery ◽  
Artery Aneurysm ◽  
Aneurysm Rupture ◽  
Basilar Artery Aneurysm

Endovascular treatment of a fusiform basilar artery aneurysm using multiple “in-stent stents”

2009 ◽  
Vol 3 (6) ◽  
pp. 496-500 ◽  
Author(s):  
R. Webster Crowley ◽  
Avery J. Evans ◽  
Neal F. Kassell ◽  
Mary E. Jensen ◽  
Aaron S. Dumont
Keyword(s):  
Basilar Artery ◽  
Pediatric Patients ◽  
Artery Aneurysm ◽  
Mass Effect ◽  
High Morbidity ◽  
Endovascular Techniques ◽  
Basilar Artery Aneurysm ◽  
Open Surgical Treatment ◽  
Cumulative Risks ◽  
Frequent Presence

Fusiform aneurysms of the basilar artery present difficult challenges for the treating physician. On one hand, these aneurysms are difficult and dangerous to treat. On the other, the relatively high rupture rate, risk of thromboemboli, and the frequent presence of mass effect on the brainstem often demand treatment rather than observation. While conservative treatment may be reasonable in an elderly patient, the relative resiliency and the larger lifetime cumulative risks of pediatric patients are compelling arguments for treatment. With the advancement of endovascular techniques some of these lesions have become treatable without the high morbidity and mortality rates associated with open surgical treatment, albeit with risks of their own. The authors present the case of a fusiform aneurysm arising from a severely tortuous basilar artery in a 22-month-old boy. The aneurysm was successfully treated using flow diversion by placing multiple intracranial stents without coil embolization. This allowed for thrombosis of the aneurysm and resolution of the mass effect on the brainstem without compromising blood flow to the brainstem.

Broad Neck Basilar Tip Aneurysm Treated by Neck Plastic Intra-Aneurysmal GDC Embolisation with Protective Balloon

1997 ◽  
Vol 3 (2) ◽  
pp. 167-170 ◽  
Author(s):  
A. Takahashi ◽  
M. Ezura ◽  
T. Yoshimoto
Keyword(s):  
Basilar Artery ◽  
Balloon Catheter ◽  
Artery Aneurysm ◽  
Detachable Coil ◽  
Guglielmi Detachable Coil ◽  
Left Posterior ◽  
Basilar Artery Aneurysm ◽  
Basilar Tip Aneurysm ◽  
Aneurysmal Neck ◽  
The Stability

A 56-year-old male was found to have a basilar artery aneurysm by magnetic resonance imaging. Angiography demonstrated a broad neck basilar tip aneurysm. He refused surgical clipping but accepted intravascular embolisation. Introducing catheters were inserted into each of the bilateral vertebral arteries. A microcatheter was introduced into the aneurysm through one of the introducing catheters and a double lumen balloon catheter was introduced into the left posterior cerebral artery (PCA) through the other. The balloon was located from the left PCA to the basilar artery across the aneurysmal neck with the aid of a guidewire passed through the inner lumen of the balloon catheter. The balloon was inflated, and a Guglielmi detachable coil (GDC) was inserted until the platinum part was placed inside the aneurysm. The balloon was deflated to confirm the stability of the GDC, and then the GDC was electrically detached. This procedure was repeated until nine GDCs were successfully inserted. The aneurysm was tightly embolised despite its broad neck. Angiography comfirmed complete neck closure and stable preservation of the basilar artery and bilateral PCAs immediately, 1 week, 3 months, 6 months, and 12 months after embolisation without evidence of thrombo-embolic complications. Neck plastic intra-aneurysmal GDC embolisation using a protective balloon can be used to treat broad-neck aneurysms.

scholarly journals Dissecting basilar artery aneurysm manifesting as sudden sensorineural hearing loss: a case report and literature review

2019 ◽  
Vol 47 (11) ◽  
pp. 5844-5848
Author(s):  
Yi-zhi Zhang ◽  
Qiu-hui Chen ◽  
Zhan-chuan Liu ◽  
Ying Zhang ◽  
Yan-qiu Han ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Case Report ◽  
Literature Review ◽  
Sensorineural Hearing Loss ◽  
Basilar Artery ◽  
Artery Aneurysm ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
First Case ◽  
Basilar Artery Aneurysm

Highlights • Dissecting basilar artery aneurysm (DBAA) is relatively rare. • We report the first case of a DBAA manifesting as sudden sensorineural hearing loss. • This case report adds to the symptom spectrum of DBAA.

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