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Updated: Oct 12, 2025
Myocardial Infarction by Percutaneous Embolization Coil Deployment in a Swine Model
Published on: November 4, 2021
Horizontal stent deployment via extracranial-intracranial bypass in coil embolization of basilar apex aneurysms:
Taichi Ishiguro1, Akitsugu Kawashima2, Shunsuke Nomura2
1Department of Neurosurgery, Tokyo Women's Medical University Yachiyo Medical Center, 477-96, Owadashinden, Yachiyo, Chiba, 276-8524, Japan. ishiguro.taichi@twmu.ac.jp.
Background:
The endovascular treatment of large, wide-necked basilar apex aneurysms (BAAs) remains challenging. Although horizontal stent deployment across both P1 segments of the posterior cerebral arteries (PCAs) would be an optimal strategy in coil embolization of wide-necked BAAs, this is only feasible in cases with anatomically favorable access. In rare circumstances, large-diameter conduits of extracranial-intracranial (EC-IC) bypass can also provide a good access route for endovascular treatment of complex intracranial aneurysms.
Methods:
We describe the technique of accessing the PCA via EC-IC bypass grafts and deploying a stent horizontally across the neck of BAA and its coil embolization. We provide a detailed technical review and describe some pitfalls of the procedure.
Results:
Two patients underwent EC-IC bypass surgery prior to the treatment of a large, wide-necked BAA. The radial artery and saphenous vein were used as grafts, respectively. To facilitate coil embolization for a large BAA, a PCA-to-PCA horizontal stent was deployed via the bypass graft. Trans-cell and jailing techniques were used, respectively. Both aneurysms were completely occluded, and the patients were discharged without any neurological deficit.
Conclusion:
Horizontal stent deployment via EC-IC bypass grafts can be performed safely, providing proper closure of the aneurysmal neck and apposition to both PCAs, facilitating complete coil embolization.
