Transcirculation balloon-assisted stent-supported coil embolization of a basilar tip aneurysm

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We present the case of a balloon-assisted, stent-supported coil embolization of a basilar tip aneurysm. Initially, a balloon extending from the basilar artery into the right PCA was placed.3 However, even with a more proximal purchase, coils were found to impinge on the left PCA. Subsequently, a transcirculation approach was performed, where the left posterior communicating artery was utilized as a conduit for balloon support and the coils were embolized from the ipsilateral vertebral artery.1 However, after this transcirculation approach was completed, there was a coil tail extruding from the aneurysm. The balloon was then removed over an exchange wire and a horizontal stent advanced, spanning the entire neck of the aneurysm, eliminating the extruded coil.2

The video can be found here: http://youtu.be/bMbtZoPnYvo.

We present the case of a balloon-assisted, stent-supported coil embolization of a basilar tip aneurysm. Initially, a balloon extending from the basilar artery into the right PCA was placed.3 However, even with a more proximal purchase, coils were found to impinge on the left PCA. Subsequently, a transcirculation approach was performed, where the left posterior communicating artery was utilized as a conduit for balloon support and the coils were embolized from the ipsilateral vertebral artery.1 However, after this transcirculation approach was completed, there was a coil tail extruding from the aneurysm. The balloon was then removed over an exchange wire and a horizontal stent advanced, spanning the entire neck of the aneurysm, eliminating the extruded coil.2

The video can be found here: http://youtu.be/bMbtZoPnYvo.

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Article Information

Address correspondence to: Dr. Vijay Agarwal, Division of Neurosurgery, DUMC 3807, Durham, North Carolina 27710. email: vijay.j.agarwal@duke.edu.

Please include this information when citing this paper: DOI: 10.3171/2014.V2.FOCUS14182.

© AANS, except where prohibited by US copyright law.

References

  • 1

    Albuquerque FCGonzalez LFHu YC: Transcirculation endovascular treatment of complex cerebral aneurysms: technical considerations and preliminary results. Neurosurgery 68:8208292011

  • 2

    Chalouhi NJabbour PGonzalez LF: Safety and efficacy of endovascular treatment of basilar tip aneurysms by coiling with and without stent assistance: a review of 235 cases. Neurosurgery 71:7857942012

  • 3

    Chalouhi NStarke RMKoltz MT: Stent-assisted coiling versus balloon remodeling of wide-neck aneurysms: comparison of angiographic outcomes. AJNR Am J Neuroradiol 10:198719922013

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