ArticleJournal of neuroendovascular therapy2026
Apparent Shift in the Angiographic Origin of the Artery of Percheron Enabling Staged Embolization of a Partially Thrombosed Basilar Tip Aneurysm: A Case Report.
Article in Journal of neuroendovascular therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: Preserving a perforating artery incorporated into a basilar tip aneurysm is challenging, particularly in partially thrombosed intracranial aneurysms (PTIAs), and treatment is frequently limited to partial embolization alone. Case Presentation: A 53-year-old woman presented with diplopia caused by an 18-mm partially thrombosed basilar tip aneurysm. An artery of Percheron appeared on angiography to arise from the aneurysm wall, and maximum-intensity projection images of DSA confirmed that this single trunk supplied both paramedian thalami. Partial coil embolization was performed to preserve the perforator. During follow-up, the aneurysm enlarged, and the angiographic origin of the perforator appeared to shift toward the neck. This apparent change allowed for safe 2nd-stage stent-assisted coil embolization with preservation of the perforator. The patient remained asymptomatic; at the latest follow-up, she showed only a minor neck recurrence without apparent aneurysm enlargement, and imaging surveillance is ongoing. Conclusion: In a perforator-involving PTIA initially unsuitable for definitive embolization, the angiographic origin of the perforator may appear to shift during follow-up, opening a window for safe staged treatment. This observation derives from a single case only and should be generalized with caution.
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