title: Coil Embolization for Ruptured Basilar Tip Aneurysm After Mechanical Thrombectomy for Acute Basilar Artery Occlusion.
abstract: BACKGROUND
  There is no published report of ruptured cerebral aneurysm accompanied by target vessel occlusion. We present a case of ruptured basilar tip aneurysm with concomitant basilar artery (BA) occlusion.
  
  
  METHODS
  A 53-year-old man presented to our emergency room with the acute onset of disturbance. Plain head computed tomography showed diffuse subarachnoid hemorrhage. Computed tomography angiography and digital subtraction angiography showed a BA tip aneurysm with BA trunk occlusion. Endovascular treatment with mechanical thrombectomy using a stent retriever and coil embolization was performed. Clinical and radiologic results were good. The patient was discharged 30 days after onset (modified Rankin Scale score = 1).
  
  
  CONCLUSIONS
  We were able to recanalize the BA trunk and perform coil embolization of the ruptured BA tip aneurysm. Our case is the first published report of a ruptured aneurysm with target large-vessel occlusion. Awareness of the issues raised in this case is required to determine the best treatment strategy, and preoperative consideration allows neurointerventionalists to avoid unpleasant surprises in the angiography suite.
authors.affiliation: Department of Neurosurgery, Osaka Police Hospital, Tennoji, Osaka, Japan.
authors.forename: Shuta
authors.initials: S
authors.lastname: Aketa
authors.affiliation: Department of Neurosurgery, Osaka Police Hospital, Tennoji, Osaka, Japan. Electronic address: wajima@naramed-u.ac.jp.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Wajima
authors.affiliation: Department of Neurosurgery, Osaka Police Hospital, Tennoji, Osaka, Japan.
authors.forename: Taekyun
authors.initials: T
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Osaka Police Hospital, Tennoji, Osaka, Japan.
authors.forename: Rinsei
authors.initials: R
authors.lastname: Tei
authors.affiliation: Department of Neurosurgery, Osaka Police Hospital, Tennoji, Osaka, Japan.
authors.forename: Taiji
authors.initials: T
authors.lastname: Yonezawa
mesh_terms: D000208:Acute Disease; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D004621:Embolization, Therapeutic / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D061185:Mechanical Thrombolysis / Q000009:adverse effects*; D008875:Middle Aged; D016896:Treatment Outcome
keywords: Aneurysm; Embolization; Occlusion; Subarachnoid hemorrhage