Elsevier

World Neurosurgery

Volume 74, Issue 1, July 2010, Pages 143-144
World Neurosurgery

Peer-Review Report
X-Configuration Stent-Assisted Coiling

https://doi.org/10.1016/j.wneu.2010.02.004Get rights and content

Background

Proximal basilar artery aneurysms are rare and when they occur they are often found in association with a fenestrated basilar artery. These lesions are often amenable to treatment by endovascular techniques

Case Description

A 48-year-old woman with a proximal basilar artery aneurysm was treated by reconstructing the fenestrated basilar artery, placing two stents in an X-configuration, and subsequent coiling of the wide-necked aneurysm. The lesion was successfully coiled without new neurological deficit and there was no recanalization at 15 month follow-up.

Conclusions

Reconstructing the fenestrated basilar artery with two stents in an X-configuration allows coiling of wide-necked aneurysms and is preferable to sacrificing a limb of the fenestrated basilar artery due to possibility of a physiologic significant branch off of the sacrificed limb.

Section snippets

Case Report

A 48-year-old woman with a history of subarachnoid hemorrhage from a basilar apex aneurysm, which was subsequently clipped, had an unruptured wide-necked bilobed aneurysm within a fenestrated proximal basilar artery (Figure 1). During surveillance imaging with computerized tomography angiography, the aneurysm was found to increase in size during a period of 4 years.

Preoperatively, the patient was placed on aspirin and Plavix. Primary coiling of the fenestration aneurysm was attempted but was

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    (2009)
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