title: [Combined endovascular stent implantation and coil embolization for the treatment of a vertebro-basilar fusiform aneurysm: technical case report].
abstract: We describe a case of the combined application of endovascular stent implantation and Guglielmi detachable coil packing for the treatment of a vertebro-basilar fusiform aneurysm and review the literature on stent placement to treat cerebral aneurysms. A 70-year-old female presented with an acute headache from subarachnoid hemorrhage. A fusiform aneurysm with a broad-based neck and dome, measuring 15 mm, involving the union of the vertebral arteries and the proximal basilar artery was demonstrated on cerebral angiography. The aneurysm was judged to be inoperable and treated conservatively. Twelve days later the patient was transferred to our hospital for endovascular therapy. An intravascular stent (MultiLink) was placed across the base of the aneurysm through the right vertebral artery. After this, coil placement in the aneurysm around the stent was performed via a microcatheter guided from the left vertebral artery. After that a microcatheter was guided from the right vertebral artery through the interstices of the stent into the aneurysm, and additional coils were placed. Final angiography showed subtotal occlusion of the aneurysm and excellent blood flow of the parent artery through the stent. There were no new neurological deficits. Neither rerupture nor ischemic event has occurred. The use of stents provides another treatment for managing the difficult entity of intracranial aneurysms.
authors.affiliation: Department of Neurosurgery, Faculty of Medicine, Kyoto University, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Morizane
authors.forename: N
authors.initials: N
authors.lastname: Sakai
authors.forename: I
authors.initials: I
authors.lastname: Nagata
authors.forename: I
authors.initials: I
authors.lastname: Nakahara
authors.forename: H
authors.initials: H
authors.lastname: Sakai
authors.forename: H
authors.initials: H
authors.lastname: Kikuchi
mesh_terms: D000208:Acute Disease; D000368:Aged; D017542:Aneurysm, Ruptured / Q000150:complications / Q000628:therapy*; D001488:Basilar Artery; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000628:therapy*; D015607:Stents; D013345:Subarachnoid Hemorrhage / Q000209:etiology; D016896:Treatment Outcome; D014711:Vertebral Artery