Four flow diverter stents for the treatment of a giant unruptured vertebrobasilar dissecting aneurysm: A case report.

The use of four consecutive flow diverter stents to treat a giant unruptured fusiform vertebrobasilar dissecting aneurysm (VBDA) is extremely rare, and their safety and efficacy have not been fully established. This case report describes the case of a middle-aged Chinese male patient who underwent endovascular treatment for a giant unruptured fusiform VBDA using four flow diverter stents deployed in a bridging sequence. Digital subtraction angiography revealed a fusiform aneurysm extending from the V4 segment of the left vertebral artery to the mid-basilar artery, measuring approximately 7.90 mm × 64.5 mm. The procedure achieved complete aneurysm occlusion and satisfactory arterial remodeling without significant thrombosis. The patient successfully underwent endovascular treatment with four flow diverter stents, resulting in stable flow in the reconstructed parent artery. At 12-month follow-up, no new neurological deficits were observed. This case provides valuable insights into the management of giant unruptured posterior circulation fusiform aneurysms, particularly in patients with well-developed bilateral vertebral arteries and posterior inferior cerebellar arteries.