Endovascular treatment of kissing aneurysms at the fenestrated basilar artery. Case report with literature review.
BACKGROUND
Basilar artery fenestrations are most commonly located in the proximal basilar trunk close to the vertebrobasilar junction and may harbor saccular aneurysms. Surgical treatment of such aneurysms has been reported in several cases previously, despite the difficulty of the surgical approach. Endovascular treatment may provide a more convenient treatment alternative in such cases. This case is also interesting in that two discrete aneurysms arise from each limb of the fenestration.


METHODS
A 20-year-old man presented with acute subarachnoid hemorrhage. He had two kissing aneurysms at the fenestrated proximal basilar artery as demonstrated by MRA and selective angiography. The two aneurysms were successfully treated with GDCs via the contralateral vertebral arteries. One-year control angiogram showed stable occlusion.


CONCLUSIONS
Aneurysms at the fenestrated basilar artery may be effectively treated with endovascular coil occlusion. The occurrence of multiplicity and the treatment alternatives are discussed, with relevant literature review.
D000328:Adult; D002533:Cerebral Angiography; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D018810:Magnetic Resonance Angiography; D008297:Male; D014656:Vascular Surgical Procedures