title: [Endovascular coiling of thrombosed basilar tip aneurysm using double stents in a y-configuration].
abstract: Recent advances in endovascular techniques greatly improved the ability to treat complex cerebral aneurysms. However, patients with wide-necked cerebral aneurysms have posed a special challenge to conventional endovascular therapy. We report a novel method of embolizing wide-necked basilar apex aneurysms by employing a Y-configuration, double stent technique. A 40-year-old woman with a partially thrombosed basilar apex aneurysm transferred to our hospital after diagnosis of subarachnoid hemorrhage. Cerebral angiography revealed a wide-necked aneurysm which neck was incorporating the origins of both the posterior cerebral arteries. In treatment procedure, a microcatheter was inserted into the aneurysm followed by coiling of the upper half of the dome. Next, the first stent was deployed in the right P2 segment extending down to the mid basilar artery and the second stent was then deployed with half of the stent in the left P2 and the other half within the lumen of the previously placed stent. Finally, the microcatheter was withdrawn near the neck, and the rest of the aneurysmal dome was packed by additional coils. The result was favorable. Successful coil embolization of a wide-necked bifurcation aneurysm can be achieved by using the double stenting Y-configuration in this case. This result continues to provide highly encouraging support of this novel technique to treat a subset of complex, wide-necked aneurysms that until recently were considered poor candidates for endovascular therapies.
authors.affiliation: Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Otani
authors.forename: Kenji
authors.initials: K
authors.lastname: Sugiu
authors.forename: Koji
authors.initials: K
authors.lastname: Tokunaga
authors.forename: Tomohito
authors.initials: T
authors.lastname: Hishikawa
authors.forename: Hisakazu
authors.initials: H
authors.lastname: Itami
authors.forename: Masafumi
authors.initials: M
authors.lastname: Hiramatsu
authors.forename: Yu
authors.initials: Y
authors.lastname: Okuma
authors.forename: Isao
authors.initials: I
authors.lastname: Date
mesh_terms: D000328:Adult; D001488:Basilar Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D002533:Cerebral Angiography / Q000379:methods; D004621:Embolization, Therapeutic / Q000379:methods; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery*; D020769:Posterior Cerebral Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D015607:Stents; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures