title: Treatment of basilar tip aneurysms with horizontal PCA to PCA stent-assisted coiling: case series.
abstract: OBJECTIVE
  Coiling of wide-necked basilar tip aneurysms is technically challenging and is often assisted by the placement of a stent. Stent placement in an anterograde fashion either with a single or Y-stent is typical. However, in some cases the posterior cerebral artery (PCA) angle of origin at the base of the aneurysm precludes anterograde catheterization. A series of patients with wide-necked basilar tip aneurysms treated with a single stent placed via the posterior communicating artery from PCA to PCA is presented.
  
  
  METHODS
  A retrospective database review was performed to identify all stent-coiled basilar tip aneurysms. Patients with attempted horizontal P1-P1 stenting via the posterior communicating artery were identified. Procedural imaging, follow-up angiography and clinical notes were reviewed.
  
  
  RESULTS
  P1-P1 stenting was attempted in 10 patients and was successful in eight. Angiographic follow-up was available in six patients, all of whom had >90% obliteration at last follow-up. There was one procedure-related subarachnoid hemorrhage that resulted in patient death. There were no cases of significant PCA stenosis on angiographic follow-up.
  
  
  CONCLUSIONS
  This stenting technique is an effective way to treat wide-necked basilar tip aneurysms but is limited by the anatomy of the posterior communicating arteries and P1 segments.
authors.affiliation: Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Missouri 63110, USA. spirosblackburn@gmail.com
authors.forename: Spiros L
authors.initials: SL
authors.lastname: Blackburn
authors.forename: Yasha
authors.initials: Y
authors.lastname: Kadkhodayan
authors.forename: Eugenia
authors.initials: E
authors.lastname: Shekhtman
authors.forename: Colin P
authors.initials: CP
authors.lastname: Derdeyn
authors.forename: DeWitte T
authors.initials: DT
authors.lastname: Cross
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Moran
mesh_terms: D057510:Endovascular Procedures / Q000295:instrumentation / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000601:surgery*; D020769:Posterior Cerebral Artery / Q000000981:diagnostic imaging* / Q000601:surgery*; D011859:Radiography; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome