PT - JOURNAL ARTICLE AU - Blackburn, Spiros L AU - Kadkhodayan, Yasha AU - Shekhtman, Eugenia AU - Derdeyn, Colin P AU - Cross, DeWitte T AU - Moran, Christopher J TI - Treatment of basilar tip aneurysms with horizontal PCA to PCA stent-assisted coiling: case series AID - 10.1136/neurintsurg-2012-010301 DP - 2013 May 01 TA - Journal of NeuroInterventional Surgery PG - 212--216 VI - 5 IP - 3 4099 - http://jnis.bmj.com/content/5/3/212.short 4100 - http://jnis.bmj.com/content/5/3/212.full SO - J NeuroIntervent Surg2013 May 01; 5 AB - Backgroun and objective Coiling of wide-necked basilar tip aneurysms is technically challenging and is often assisted by the placement of a stent. Stent placement in an anterograde fashion either with a single or Y-stent is typical. However, in some cases the posterior cerebral artery (PCA) angle of origin at the base of the aneurysm precludes anterograde catheterization. A series of patients with wide-necked basilar tip aneurysms treated with a single stent placed via the posterior communicating artery from PCA to PCA is presented. Methods A retrospective database review was performed to identify all stent-coiled basilar tip aneurysms. Patients with attempted horizontal P1–P1 stenting via the posterior communicating artery were identified. Procedural imaging, follow-up angiography and clinical notes were reviewed. Results P1–P1 stenting was attempted in 10 patients and was successful in eight. Angiographic follow-up was available in six patients, all of whom had >90% obliteration at last follow-up. There was one procedure-related subarachnoid hemorrhage that resulted in patient death. There were no cases of significant PCA stenosis on angiographic follow-up. Conclusions This stenting technique is an effective way to treat wide-necked basilar tip aneurysms but is limited by the anatomy of the posterior communicating arteries and P1 segments.