Introduction This case study aims to elucidate the procedural challenges and outcomes of endovascular treatment for a basilar artery fusiform aneurysm using a braided nitinol stent, highlighting the importance of meticulous technique and preoperative planning

Case Description A 56-year-old female presented with recurrent posterior circulation strokes attributed to a fusiform aneurysm involving the basilar artery, complicated by hypoplastic right vertebral artery and tortuous left vertebral artery. Endovascular intervention was pursued to mitigate the risk of further cerebrovascular events. Preoperatively, the patient received oral Brilinta and aspirin. Access was achieved via the right femoral artery, with navigation to the basilar artery using a 6 French DAC Fargomax catheter. Deployment of a LEO + 0.45cm *75 mmbraided nitinol stent was performed via a VASCO + 25 MP microcatheter, with careful anchoring and expansion. Procedural adjustments were made to address flow occlusion encountered due to increased catheter caliber.

Results Despite technical challenges, successful stent deployment was achieved, and the Leo stent was detached without complications. Post-procedural and followup 3-month angiography revealed satisfactory stent positioning and flow restoration. Endovascular treatment of a basilar artery fusiform aneurysm using a braided nitinol stent demonstrated feasibility and efficacy, albeit with procedural intricacies. Meticulous technique, precise stent deployment, and preoperative antiplatelet therapy are crucial considerations for optimizing outcomes in such complex cerebrovascular interventions. This case underscores the importance of tailored approaches and careful procedural planning in managing challenging cerebrovascular pathologies.

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Abstract P032 Figure 1

Disclosure of Interest no.