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"Double barrel" stent reconstruction of a symptomatic fusiform basilar artery aneurysm.
MedLine Citation:
PMID:  21311374     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND AND IMPORTANCE:: Giant fusiform aneurysms of the basilar artery are associated with a high rate of morbidity and mortality. Treatment of these lesions can be difficult, especially when there are poor anatomic collaterals such as posterior communicating arteries. Often times these lesions have no acceptable treatment. The authors present a case of a patient with a symptomatic, fusiform basilar artery aneurysm successfully treated with a side by side (double barrel), telescoping stent construct. CLINICAL PRESENTATION:: A 56 year old man presented with chief complaints of dysarthria and left sided hemiparesis. MRI and conventional catheter based angiography revealed a dolichoectatic basilar artery with 3 large fusiform aneurysms throughout its length. Flow through the patient's aneurysm was successfully reduced with a side by side stent construct and coiling of the proximal aneurysm dilation. The patient experienced stabilization of his ischemic events and neurologic recovery. A total of six Neurform-2 4.5 x 30 mm stents were navigated and positioned from the proximal posterior cerebral arteries to the distal vertebral arteries in a side by side (double barrel), telescoping manner. These were deployed simultaneously by two operators to oppose the stent struts as well as the arterial wall. Next the proximal aneurysmal dilation was coiled to near occlusion. Successful flow re-direction and aneurysm thrombosis was observed. CONCLUSION:: A novel, endovascular stenting technique for successfully treating symptomatic, giant basilar artery aneurysms is presented. The above patient at 4 months was living independently with no further neurologic events or decline.
Authors:
Mark Bain; Muhammad Shazam Hussain; Alejandro Spiotta; Vivekananda Gonugunta; Shaye Moskowitz; Rishi Gupta
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-09
Journal Detail:
Title:  Neurosurgery     Volume:  -     ISSN:  1524-4040     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1Cerebrovascular Center, The Cleveland Clinic Foundation; 2Department of Neurosurgery, Marshfield Clinic; 3Vanderbilt Stroke Center, Vanderbilt University.
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