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Cover Neurosurgical Focus: Video

Combined deconstructive and reconstructive treatment of a giant vertebrobasilar fenestration aneurysm

Lorenzo Rinaldo, Soliman Oushy, and Giuseppe Lanzino

Aneurysms associated with a vertebrobasilar fenestration are rare lesions and can grow to a giant size, presenting significant therapeutic challenges. Endovascular treatment of these aneurysms has traditionally been with coiling; however, flow diverter placement within the fenestration arms has recently proven to be a viable treatment strategy. The authors present a case of a giant vertebrobasilar fenestration aneurysm in a patient presenting with a cranial nerve VI palsy. The lesion was treated by using a combination of flow diverter placement and vertebral artery sacrifice. The nuances of flow diversion therapy for these aneurysms and the management of intra- and postoperative complications are discussed.

The video can be found here: https://stream.cadmore.media/r10.3171/2022.7.FOCVID2256