ArticleJournal of neuroendovascular therapy2025
Eleven-Year Follow-Up of a Ruptured Basilar Artery Trunk Dissecting Aneurysm Treated with Coiling and Multiple Overlapping Stents.
Article in Journal of neuroendovascular therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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3 authors.
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Abstract
Objective: Ruptured dissecting aneurysm of the basilar artery trunk is a rare condition associated with high morbidity and mortality. Due to limited data, definitive treatment options and long-term radiological outcomes remain unclear. This report presents the 11-year radiographic follow-up of a dissecting basilar artery trunk aneurysm that presented with severe subarachnoid hemorrhage (SAH) and was managed with 4 endovascular interventions, including coiling and overlapping Enterprise Vascular Reconstruction Device (Johnson & Johnson, Miami, FL, USA) stent placements. Case Presentation: A 32-year-old male with World Federation of Neurosurgical Surgeons Grade V SAH was transferred to our institution for the treatment of a 4-mm sidewall aneurysm of the basilar artery trunk. The lesion was initially managed on Day 1 with balloon-assisted coiling using a double microcatheter technique, achieving satisfactory occlusion. However, progressive aneurysm enlargement necessitated a 2nd intervention on Day 14, during which additional coils were deployed and 2 overlapping stents were placed. As the aneurysm continued to expand, reaching 10 mm by Day 32, a 3rd coiling procedure was performed. A 4th intervention-entailing further coiling and the placement of 2 additional overlapping stents-was completed 4 months following the initial event. The patient recovered without neurological deficits. During an 11-year follow-up, which included annual MRA and a 5-year interval DSA, a small residual at the aneurysm base detected at the 5-year follow-up demonstrated a gradual increase in size by 1.0 mm over 6 years. Despite this growth, the patient remained clinically stable. Conclusion: Sustained prevention of re-rupture in a basilar artery trunk dissecting aneurysm was achieved through multiple overlapping stents combined with coil embolization, although aneurysm recurrence was not entirely controlled. Further investigation into more definitive therapies-such as flow-diverting devices-is warranted to achieve durable, curative outcomes.
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