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Treatment of coil embolization failed recurrent giant basilar tip aneurysms with bypass and surgical occlusion
  1. Dinesh Ramanathan1,
  2. Jeremy Ciporen1,
  3. Basavaraj Ghodke1,2,
  4. Richard G Ellenbogen1,
  5. Laligam N Sekhar1,2
  1. 1Department of Neurosurgery, University of Washington, Seattle, Washington, USA
  2. 2Department of Radiology, University of Washington, Seattle, Washington, USA
  1. Correspondence to Laligam N Sekhar, Professor and Vice-Chairman, Department of Neurological Surgery, Professor, Department of Radiology, University of Washington, Seattle, WA 98104, USA; lsekhar{at}


Giant basilar tip aneurysms are a challenge to treat because of the complex anatomy and critical vessels that arise in this region. For large aneurysms, with multiple recurrences after coiling, when microsurgical clipping is not possible, a bypass to the posterior cerebral artery (PCA) can be helpful in providing definitive treatment. Two patients with giant basilar tip aneurysms were treated with bypass to the PCA. One patient had a microsurgical clipping and the other had a proximal occlusion of the basilar artery along with the bypass. Long-term angiographic and clinical follow-up was obtained. One patient had marked improvement in symptoms and a stable aneurysm remnant and the other patient had complete occlusion. Surgical treatment with a bypass to the PCA, with clipping of the aneurysm or proximal ligation of the basilar artery can be an effective treatment option for giant basilar tip aneurysms.

  • Basilar tip aneurysm
  • stent assisted coiling
  • cerebral revascularization
  • brain
  • aneurysm
  • stroke
  • coil
  • stent

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  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval This study was conducted with the approval of the Institutional review board, University of Washington.

  • Provenance and peer review Not commissioned; externally peer reviewed.