Endovascular treatment of a symptomatic extracranial vertebral artery aneurysm

Aneurysms of the extracranial vertebral artery are uncommon, with most cases attributed to penetrating head and neck trauma. We report a 29-year-old man with a symptomatic proximal extracranial vertebral artery aneurysm of unclear etiology. This patient's aneurysm was definitively treated after a successful balloon occlusion test of his affected vertebral artery. An endovascular approach was used combining coil embolization of the distal vertebral artery and a covered stent graft in the subclavian. Although aneurysms of this size and location are traditionally repaired with open aneurysmectomy, we show that endovascular approaches can be a safe and effective alternative.