Stent-assisted coiling of a ruptured basilar artery perforator aneurysm: A case report.

Jongwon Cho, Sang Hyun Suh, Joonho Chung
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Abstract

Basilar artery (BA) perforator aneurysms are exceedingly rare causes of subarachnoid hemorrhage. Therefore, the natural history and optimal treatment have not been established, and surgical, endovascular, and conservative management have been used. However, there is no consensus on the optimal treatment strategy. Herein, we report the case of a 52-year-old man presenting with a ruptured BA perforator aneurysm. First, we deployed an Enterprise stent from the left P1 segment to the BA because the microcatheter could not enter the aneurysm. Then, we deployed a helical coil on the orifice of the BA perforator. Finally, we deployed another Enterprise stent, sandwiching the helical coil between the two Enterprise stents. The aneurysm was completely obliterated without recurrence on the follow-up angiography. Our technique of sandwiching the small helical coil between two Enterprise stents might help other surgeons by offering another feasible treatment option for ruptured BA perforator aneurysms.

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支架辅助盘绕破裂基底动脉穿支动脉瘤1例。
基底动脉穿支动脉瘤是极为罕见的蛛网膜下腔出血的病因。因此,自然病史和最佳治疗尚未确定,手术、血管内治疗和保守治疗均被采用。然而,对于最佳治疗策略尚无共识。在此,我们报告一个52岁的男性表现为破裂的BA穿支动脉瘤。首先,由于微导管无法进入动脉瘤,我们将Enterprise支架从左侧P1段置入到BA。然后,我们在BA射孔器的孔口上部署了螺旋线圈。最后,我们部署了另一个企业号支架,将螺旋线圈夹在两个企业号支架之间。在随后的血管造影中,动脉瘤完全消失,无复发。我们将小螺旋线圈夹在两个Enterprise支架之间的技术可能会为其他外科医生提供另一种可行的治疗方案,以治疗破裂的BA穿支动脉瘤。
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