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Case series
Flow diverter stent treatment for ruptured basilar trunk perforator aneurysms
  1. Simone Peschillo1,
  2. Alessandro Caporlingua2,
  3. Delia Cannizzaro2,
  4. Mariachiara Resta3,
  5. Nicola Burdi3,
  6. Luca Valvassori4,
  7. Guglielmo Pero4,
  8. Giuseppe Lanzino5
  1. 1Department of Neurology and Psychiatry, Endovascular Neurosurgery/Interventional Neuroradiology, ‘Sapienza’ University of Rome, Rome, Italy
  2. 2Department of Neurology and Psychiatry, Neurosurgery, ‘Sapienza’ University of Rome, Rome, Italy
  3. 3Department of Radiology–Neuroradiology, Ospedale SS Annunziata ASL Taranto, Taranto, Italy
  4. 4Department of Neuroradiology, Ospedale Niguarda Ca’ Granda, Milano, Italy
  5. 5Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
  1. Correspondence to Dr S Peschillo, Department of Neurology and Psychiatry, Endovascular Neurosurgery/Interventional Neuroradiology, ‘Sapienza’ University of Rome, Rome, Italy, Viale del Policlinico 155, Rome 00100, Italy; simone.peschillo{at}


Objective Basilar trunk perforator (BTP) aneurysms are rare. Treatment options traditionally considered for these uncommon lesions have included direct surgery, endovascular therapy, or conservative management. Flow diverters represent a newer therapeutic option for BTP aneurysms but pitfalls and complications are unknown. We describe three patients with BTP aneurysms treated with flow diverter stents.

Methods All three patients had ruptured BTP aneurysms and, after loading doses of dual antiplatelet agents, underwent treatment with a flow diverter alone (two patients) or in combination with an intracranial stent (one patient).

Results Complications directly (two thromboembolic events) or indirectly (one hemorrhage at the external ventricular drain site, probably facilitated by the dual antiplatelet therapy) occurred in all three patients and resulted in permanent morbidity in one case. Imaging follow-up confirmed obliteration in all three patients, and no episodes of rebleeding from the aneurysms were observed at follow-up.

Conclusions Flow diverters are effective in obliterating BTP aneurysms. However, given the challenges and complications encountered, especially in patients with ruptured lesions, their use must be carefully weighed against other available therapeutic modalities, including observation.

  • Aneurysm
  • Flow Diverter
  • Hemorrhage
  • Technique
  • Subarachnoid

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