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Basilar Artery Trunk Aneurysm: A Complex Aneurysm at a Basilar Artery Trunk Fenestration, Treated with Comaneci-Assisted Coil Occlusion

  • Stanimir SirakovEmail author
  • Alexander Sirakov
Living reference work entry
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Abstract

A 57-year-old female patient presented to our hospital with a 3-month history of severe recurrent headaches. At the time of admission, the patient was neurologically intact with a Glasgow Coma Scale score of 15. There was no evidence of focal neurologic deficit or cranial nerve lesions, but there was subtle neck stiffness. Computed tomography angiography (CTA) demonstrated a saccular aneurysm associated with a fenestration of the basilar artery (BA) trunk with no evidence of subarachnoid hemorrhage (SAH). The wide-necked aneurysm was treated by endovascular coil occlusion assisted by a temporary neck-bridging device (Comaneci). This is a new option for the endovascular treatment of wide-necked aneurysms including those associated with a fenestration. The patient tolerated the procedure well, and there was no resulting neurological deficit. Follow-up DSA at 3 months confirmed the complete occlusion of the aneurysm. The use of the Comaneci as an assist device for coil occlusion in aneurysms associated with a fenestration of the parent artery is the main topic of this chapter.

Keywords

Basilar artery Fenestration Comaneci device Temporary stent-assisted coiling Wide-necked aneurysm 

References

  1. Campos J, Fox AJ, Viñuela F, Lylyk P, Ferguson GG, Drake CG, Peerless SJ. Saccular aneurysms in basilar artery fenestration. AJNR Am J Neuroradiol. 1987;8(2):233–6.
  2. Finlay HM, Canham PB. The layered fabric of cerebral artery fenestrations. Stroke. 1994;25(9):1799–806.
  3. Islak C, Kocer N, Kantarci F, Saatci I, Uzma O, Canbaz B. Endovascular management of basilar artery aneurysms associated with fenestrations. AJNR Am J Neuroradiol. 2002;23(6):958–64.
  4. Juszkat R, Nowak S, Moskal J, Kociemba W, Zarzecka A. Endovascular treatment of basilar artery aneurysms associated with distal fenestration. A case report. Interv Neuroradiol. 2009;15(1):109–11.  .
  5. Kulcsár Z, Ernemann U, Wetzel SG, Bock A, Goericke S, Panagiotopoulos V, Forsting M, Ruefenacht DA, Wanke I. High-profile flow diverter (silk) implantation in the basilar artery: efficacy in the treatment of aneurysms and the role of the perforators. Stroke. 2010;41(8):1690–6.  .
  6. Morrison J, Alexander MD, Dowd CF, Cooke DL. Flanking the fenestration: circumferential limb-to-limb stent-assisted coiling of a basilar artery fenestration aneurysm. J Neurointerv Surg. 2018;10(6):e12.  .
  7. O’Hare M, Hoxworth J, O’Carroll C. Fenestration of the basilar artery with associated aneurysm-a case report. Headache. 2016;56(10):1671–2.  .
  8. Saatci I, Cekirge HS, Karcaaltincaba M, Basgun N, Berker M, Timurkaynak E, Ozcan OE. Endovascular treatment of kissing aneurysms at the fenestrated basilar artery. Case report with literature review. Surg Neurol. 2002;58(1):54–8; discussion 58.
  9. Tanaka M, Kikuchi Y, Ouchi T. Neuroradiological analysis of 23 cases of basilar artery fenestration based on 2280 cases of MR angiographies. Interv Neuroradiol. 2006;12(Suppl 1):39–44.  .

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.NeuroradiologyUniversity Hospital St. Ivan RilskiSofiaBulgaria

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