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Ischemic basilar artery dissecting aneurysm treated by stenting only--case report
Mohammad A Jamous1, Koichi Satoh, Shunji Matsubara
1Department of Neurosurgery, School of Medicine, The University of Tokushima, Tokushima, Japan.
Neurologia Medico-Chirurgica
|March 17, 2004
Summary
A minimally invasive stenting procedure successfully treated a basilar artery dissecting aneurysm, leading to sac thrombosis and normal blood flow. This two-stage approach offers a promising outcome for complex cerebrovascular cases.
Area of Science:
- Neurosurgery
- Interventional Neuroradiology
- Vascular Neurology
Background:
- Dissecting aneurysms of the basilar artery pose significant risks, including stroke and hemorrhage.
- Endovascular treatment is a primary modality for managing complex intracranial aneurysms.
- Previous treatments for such aneurysms have had limited success rates.
Observation:
- A 45-year-old male presented with an enlarging basilar artery dissecting aneurysm 10 months post-brainstem infarction.
- A planned combined stenting and Guglielmi detachable coils (GDCs) procedure was initiated.
- Stent deployment was completed, but coil embolization was deferred due to contrast load concerns.
Findings:
- Follow-up cerebral angiography 10 days post-procedure revealed complete thrombosis of the aneurysm sac.
- Normal blood flow was restored in the basilar artery.
- The patient maintained good clinical and angiographic status over a 2-year follow-up period.
Implications:
- Stenting alone can effectively lead to aneurysm sac obliteration, suggesting a potential for simplified treatment.
- A staged endovascular approach, utilizing stenting followed by delayed coil embolization if necessary, is a viable strategy.
- This case highlights the efficacy of endovascular stenting in managing complex dissecting aneurysms with favorable long-term results.