Treatment of symptomatic fusiform aneurysm in basilar artery by stenting following coiling technique

The present stent-assisted coil technique has many limitations especially in treating fusiform aneurysms. We aimed to introduce stenting following coiling technique to treat fusiform aneurysms.

From January 2009 to December 2010, we treated 6 patients with fusiform aneurysms in basilar artery (BA) by stenting following coiling technique. The 6 patients included four men and two women (age from 20 to 78 years, mean age 51 years). Two patients had subarachnoid hemorrhage, whereas 4 had unruptured aneurysms with progressive brainstem symptoms. In the procedure of endovascular treatment, the stent was delivered after coiling to compress the coils against the aneurysm wall and form a lumen in basilar artery.

Five patients had an excellent recovery with a satisfactory clinical result with an average 15.4 months follow-up. Four patients received follow-up angiographic imaging with an average 13 months, whereas 3 patients demonstrated complete aneurysm occlusion with reconstructive BA patency. Re-growth occurred in one patient, although clinically stable. None had angiographic evidence of in-stent stenosis.

Stenting following coiling technique may be a feasible and effective method to reshape parent arteries and to embolize fusiform aneurysms safely. However, this technique may be considered in selected patients.