The treatment of basilar apex aneurysms has progressively become more minimalistic in nature. Although initial coil embolizations were geared towards those aneurysms with a favorable neck to dome ratio, wide necked aneurysms have also been increasingly treated by the endovascular route. Several techniques have been described in the stent assisted coiling of basilar apex aneurysms, including the Y stent formation, waffle cone technique and horizontal stenting. Thus far, horizontal stenting has required access from a retrograde approach—namely, the posterior communicating artery. The authors describe a novel antegrade technique, through the basilar artery, for the deployment of a Neuroform-EZ stent (Boston Scientific, Natick, Massachusetts, USA) in a horizontal configuration across the neck of a basilar apex aneurysm. This approach allowed for the complete coil embolization of a wide necked basilar apex aneurysm.
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Competing interests EIL receives research grant support (principal investigator: Stent-Assisted Recanalization in acute Ischemic Stroke, SARIS), other research support (devices) and honoraria from Boston Scientific and research support from Codman & Shurtleff Inc and ev3/Covidien Vascular Therapies; has ownership interests in Intratech Medical Ltd and Mynx/Access Closure; serves as a consultant on the board of Scientific Advisors to Codman & Shurtleff Inc; serves as a consultant per project and/or per hour for Codman & Shurtleff Inc, ev3/Covidien Vascular Therapies and TheraSyn Sensors Inc; and receives fees for carotid stent training from Abbott Vascular and ev3/Covidien Vascular Therapies. EIL receives no consulting salary arrangements. All consulting is per project and/or per hour.
Patient consent Not obtained.
Provenance and peer review Not commissioned; externally peer reviewed.