Article Text
PDF
Abstract
Introduction Stent Assist Coiling of Basilar Trunk aneurysm with Basilar fenestration
Case Description 67 y/o lady present with chronic Head ache.
In the physical exam patient was Glasgow Coma Scale 15/15, without neurological deficit.
Patient was on anti-hypertensive medication.
Noncontrast Brain CT showed hyperdense vascular marker in interpeduncular cistern. (Figure 1)
Patient underwent brain CTA(Angiography) that showed unruptured basilar trunk aneurysm with basilar fenestration adjacent to aneurysm. (Figure 2)
Angiogram from left vertebral artery showed aneurysm.
For patient ASA 80 mg daily and Clopidogrel 75 mg daily started 7 days before treatment.
Before stenting 5000-unit heparin intravenous infused.
Patient schedule for endovascular treatment of aneurysm using stent assist coiling with flow diverting stent (FRED) via jailing technique. (Figure 3)
The post-intervention hospital stay was uneventful, and 6 months Modified Rankin Scale (mRS) score = 0.
DAPT continued for up to 3 months postintervention and after 3 months, clopidogrel was discontinued.
Brain CTA 6 months after endovascular treatment revealed total obliteration of aneurysm without recurrence. (Figure 4)
Non contrast Brain CT
Brain CTA in 3D reconstruction image and coronal and sagittal images
left vertebral artery angiogram
Brain CTA 6 months after treatment
Results Treatment of posterior circulation aneurysms is challenging. Endovascular treatment of this lesion needs complex approach such as stent assist or balloon assist coiling, while open surgery of these aneurysms can be associated with severe complication.
Flow diverting Stent in posterior circulation aneurysm can be safe and effective but further studies are needed.
Disclosure of Interest no.