Embolization of a wide neck giant basilar tip aneurysm using two coils. A case report

Pictorial demonstration of aneurysm lumen thrombosis and diversion of flow hemodynamics with the use of a minimum number of coils in the treatment of hemorrhagic basilar tip aneurysm. We present a 62-year-old lady who underwent endovascular treatment for acute subarachnoid hemorrhage due to a giant basilar tip aneurysm and a left carotico-ophthalmic aneurysm. Following deployment of two of the longest available coils, the procedure was terminated due to a sudden change of jet flow within the aneurysm and unsustainable coil and microcatheter positions in spite of further attempts. Post-procedural follow-up angiogram on day 22, revealed an approximately 90% occlusion of the giant basilar tip aneurysm. Significant reduction in flow dynamic by minimum number of coils can achieve remarkable and near complete thrombosis and occlusion of a giant basilar tip aneurysm.