title: Giant Basilar Artery Aneurysm Involving the Origin of Bilateral Posterior Cerebral and Superior Cerebellar Arteries: Neck Reconstruction with pCONus-Assisted Coiling.
abstract: Giant aneurysms of the basilar artery are rare and are frequently associated with obstructive hydrocephalus and brainstem compression. Treatment still remains a challenge both for neurosurgeons and for interventional neuroradiologists. Cases reported in the literature are anecdotal and, overall, their outcomes are poor. We present the case of a patient with a giant aneurysm of the basilar artery tip, involving the origin of both the posterior cerebral and superior cerebellar arteries, who underwent coiling and ventriculoperitoneal shunting for associated obstructive hydrocephalus. A pCONus ® stent (Phenox; Bochum, Germany) was detached with its petals opened over the ostia of the parent vessels, with the aim being to reconstruct the neck of the aneurysm and to preserve the flow in the parent vessel. Moreover, the presence of the stent was useful to maintain the coils within the dome of the aneurysm. The pCONus is a new neurovascular device that is also useful for treating cases of complex basilar artery aneurysms when the ostia of the parent vessel origin is at the level of the aneurysm neck.
authors.affiliation: Institute of Neurosurgery, Medical School, Catholic University of Rome, Rome, Italy. francesco.signorelli1984@gmail.com.
authors.forename: Francesco
authors.initials: F
authors.lastname: Signorelli
authors.affiliation: Institute of Neurosurgery, Medical School, Catholic University of Rome, Rome, Italy.
authors.forename: Carmelo Lucio
authors.initials: CL
authors.lastname: Sturiale
authors.affiliation: Institute of Neurosurgery, Medical School, Catholic University of Rome, Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: La Rocca
authors.affiliation: Institute of Neurosurgery, Medical School, Catholic University of Rome, Rome, Italy.
authors.forename: Alessio
authors.initials: A
authors.lastname: Albanese
authors.affiliation: Institute of Bio-Imaging, Catholic University School of Medicine, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: D'Argento
authors.affiliation: Institute of Neurosurgery, Medical School, Catholic University of Rome, Rome, Italy.
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: Mattogno
authors.affiliation: Institute of Neurosurgery, Medical School, Catholic University of Rome, Rome, Italy.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Puca
authors.affiliation: Institute of Neurosurgery, Medical School, Catholic University of Rome, Rome, Italy.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Visocchi
authors.affiliation: Institute of Neurosurgery, Medical School, Catholic University of Rome, Rome, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Marchese
authors.affiliation: Institute of Bio-Imaging, Catholic University School of Medicine, Rome, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Pedicelli
mesh_terms: D000368:Aged; D001488:Basilar Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D002531:Cerebellum / Q000098:blood supply*; D002533:Cerebral Angiography; D000072226:Computed Tomography Angiography; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods; D020769:Posterior Cerebral Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods
keywords: Basilar artery; Coiling; Giant aneurysm; Reconstructive neurosurgery; pCONus