Endovascular coiling of thrombosed basilar tip aneurysm using double stents in a Y-configuration

Yoshihiro Otani, Kenji Sugiu, Koji Tokunaga, Tomohito Hishikawa, Hisakazu Itami, Masafumi Hiramatsu, Yu Okuma, Isao Date

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Recent advances in endovascular techniques greatly improved the ability to treat complex cerebral aneurysms. However, patients with wide-necked cerebral aneurysms have posed a special challenge to conventional endovascular therapy. We report a novel method of embolizing wide-necked basilar apex aneurysms by employing a Y-configuration, double stent technique. A 40-year-old woman with a partially thrombosed basilar apex aneurysm transferred to our hospital after diagnosis of subarachnoid hemorrhage. Cerebral angiography revealed a wide-necked aneurysm which neck was incorporating the origins of both the posterior cerebral arteries. In treatment procedure, a microcatheter was inserted into the aneurysm followed by coiling of the upper half of the dome. Next, the first stent was deployed in the right P2 segment extending down to the mid basilar artery and the second stent was then deployed with half of the stent in the left P2 and the other half within the lumen of the previously placed stent. Finally, the microcatheter was withdrawn near the neck, and the rest of the aneurysmal dome was packed by additional coils. The result was favorable. Successful coil embolization of a widenecked bifurcation aneurysm can be achieved by using the double stenting Y-configuration in this case. This result continues to provide highly encouraging support of this novel technique to treat a subset of complex, wide-necked aneurysms that until recently were considered poor candidates for endovascular therapies.

Original languageEnglish
Pages (from-to)1005-1012
Number of pages8
JournalNeurological Surgery
Volume40
Issue number11
Publication statusPublished - Nov 2012

Keywords

  • Basilar tip aneurysm
  • Coil embolization
  • Stent
  • Y-configuration

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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