Intermediate-porosity stent for coil-reconstruction of mixed saccular-fusiform basilar trunk aneurysm

Vertebrobasilar junction and basilar trunk aneurysms are extremely difficult to treat, with significant morbidity associated with bypass-trapping procedures. As a result, endovascular techniques including flow diversion and stent-assisted coil embolization have become the mainstay of treatment.^1-3 Traditional flow diverters pose risk of occlusion of basilar perforator arteries while traditional stents used as adjuncts for coil-embolization often have high porosity and cannot function as flow diverters. On the other hand, the LVIS stent uniquely provides more porosity than other flow diverters,^4,5 allowing patency of perforators while also being amenable to stent-assisted coiling. We present a case of a mixed saccular and fusiform basilar trunk aneurysm that underwent LVIS stent-assisted coil embolization. Using bifemoral access with triaxial systems, one microcatheter was placed in the aneurysm sac and another was used to deploy a stent from the basilar apex into the right vertebral artery. A durable angiographic outcome was observed at 9 months.