Endovascular treatment with 'kissing' flow diverter stents of two unruptured aneurysms at a fenestrated vertebrobasilar junction.
OBJECTIVE
Fenestration of the vertebrobasilar junction (VBJ) is a rare condition which may be associated with the presence of aneurysms. The endovascular approach is usually the first-line treatment in these cases since the location of the aneurysm may be unsuitable for a surgical approach. This anatomical variation may even influence the endovascular strategy, particularly in those cases in which the sacrifice of a vessel could be avoided. This paper describes an innovative approach of flow diversion in such challenging situations.


METHODS
Two women were admitted after an occasional diagnosis of an aneurysm arising from a fenestrated VBJ. In both cases the endovascular approach was performed with two flow diverter stents and dual antiplatelet therapy was administered for 6 months.


RESULTS
Complete exclusion of the two aneurysms was obtained after 6 and 7 months, respectively, and the clinical outcome was excellent.


CONCLUSIONS
Endovascular treatment of unruptured aneurysms located on a fenestrated VBJ with flow diverter stents represents a valid therapeutic approach with excellent clinical and radiological outcomes.
Interventional Neuroradiology Unit, Careggi University Hospital, Florence, Italy. onemed21@gmail.com
Arturo
A
Consoli
Leonardo
L
Renieri
Sergio
S
Nappini
Fabrizio
F
Ricciardi
Giulia
G
Grazzini
Giulia
G
Scarpini
Leonardo
L
Capaccioli
Salvatore
S
Mangiafico
D000328:Adult; D057510:Endovascular Procedures / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000628:therapy; D008875:Middle Aged; D011859:Radiography; D015607:Stents; D016896:Treatment Outcome; D014715:Vertebrobasilar Insufficiency / Q000000981:diagnostic imaging* / Q000628:therapy