Combined endoscope-assisted transclival clipping and endovascular stenting of a basilar trunk aneurysm: case report.
OBJECTIVE
We describe a patient with a mid-basilar aneurysm treated with combined endoscope-assisted transsphenoidal clipping and endovascular stenting.


METHODS
A 28-year-old woman was transferred to the cranial base surgery center with an acute Grade III subarachnoid hemorrhage. Cerebral angiography demonstrated a small basilar trunk aneurysm that was not amenable to acute endovascular treatment.


METHODS
The patient underwent sublabial transsphenoidal/transclival endoscope-assisted clipping of the aneurysm and subsequent stenting of the affected segment. The aneurysm was repaired with a low-profile Weck clip (Weck Closure Systems Research, Triangle Park, NC) that permitted a watertight closure of the clival dura using cardiac Medtronic U-clips (Medtronic, Inc., Minneapolis, MN). Postoperatively, the patient had no evidence of cerebrospinal fluid leakage.


CONCLUSIONS
Watertight dural closure was possible due to the use of a low-profile aneurysm clip that did not protrude through the dural defect, as well as self-tying sutures.
Eloy
Jean A
JA
Department of Otolaryngology, Head and Neck Surgery, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1189, New York, NY 10029, USA. Jean.Anderson.Eloy@gmail.com
Carai
Andrea
A
Patel
Aman B
AB
Genden
Eric M
EM
Bederson
Joshua B
JB
D000328:Adult; D001807:Blood Vessel Prosthesis; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D044583:Neuroendoscopy / Q000379:methods*; D015607:Stents; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000295:instrumentation* / Q000379:methods*