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FIG 3. Case 10.
A, Left vertebral angiography obtained 6 months after previous surgery shows residual filling of the basilar tip aneurysm and additional right vertebral artery aneurysm close to the origin of the posterior inferior cerebellar artery. Right posteriocerebral artery is supplied by the right carotid circulation via right posterior communicating artery (not shown).
B, Fluoroscopic road map image during embolization with balloon remodeling technique and postembolization right vertebral angiogram (C) shows satisfactory occlusion of the aneurysm with small neck remnant, especially on the right side.
D, Follow-up angiography 22 months after the embolization reveals recanalization and regrowth of the aneurysm.
E, After placement of Neuroform stent extending from the left posterior communicating artery to the distal basilar artery recanalized portion of the aneurysm embolized with multiple coils.
F, Proximal and distal markers of second Neuroform stent, placed across the right vertebral artery aneurysm, are seen. After insertion of the first coil into the aneurysm, lumen flow within the right posterior inferior cerebellar artery is diminished. The coil is retracted and embolization is abandoned.
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