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Stent-assisted coiling of a ruptured basilar artery perforator aneurysm: A case report

Journal of Cerebrovascular and Endovascular Neurosurgery / Journal of Cerebrovascular and Endovascular Neurosurgery, (P)2234-8565; (E)2287-3139
2023, v.25 no.1, pp.81-86
https://doi.org/10.7461/jcen.2022.E2022.03.005
Jongwon Cho (Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea)
Sang Hyun Suh (Department of Radiology Gangnam Severance Hospital,Yonsei University College of Medicine,Seoul,Korea)
Joonho Chung (Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea)
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Abstract

Basilar artery (BA) perforator aneurysms are exceedingly rare causes of subarachnoid hemorrhage. Therefore, the natural history and optimal treatment have not been established, and surgical, endovascular, and conservative management have been used. However, there is no consensus on the optimal treatment strategy. Herein, we report the case of a 52-year-old man presenting with a ruptured BA perforator aneurysm. First, we deployed an Enterprise stent from the left P1 segment to the BA because the microcatheter could not enter the aneurysm. Then, we deployed a helical coil on the orifice of the BA perforator. Finally, we deployed another Enterprise stent, sandwiching the helical coil between the two Enterprise stents. The aneurysm was completely obliterated without recurrence on the follow-up angiography. Our technique of sandwiching the small helical coil between two Enterprise stents might help other surgeons by offering another feasible treatment option for ruptured BA perforator aneurysms.

keywords
Basilar artery aneurysm, Endovascular procedure, Stent, Subarachnoid hemorrhage

Journal of Cerebrovascular and Endovascular Neurosurgery