Intentional Stent Herniation Technique Using Neuroform Atlas Stent System for Embolization of a Wide-Necked Basilar Tip Aneurysm

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  • Sakata Hiroyuki
    Department of Neurosurgery, National Hospital Organization Sendai Medical Center, Sendai, Miyagi, Japan
  • Ezura Masayuki
    Department of Neurosurgery, National Hospital Organization Sendai Medical Center, Sendai, Miyagi, Japan
  • Abe Takatsugu
    Department of Neurosurgery, National Hospital Organization Sendai Medical Center, Sendai, Miyagi, Japan
  • Ishida Tomohisa
    Department of Neurosurgery, National Hospital Organization Sendai Medical Center, Sendai, Miyagi, Japan
  • Endo Hidenori
    Department of Neurosurgery, National Hospital Organization Sendai Medical Center, Sendai, Miyagi, Japan
  • Inoue Takashi
    Department of Neurosurgery, National Hospital Organization Sendai Medical Center, Sendai, Miyagi, Japan
  • Endo Toshiki
    Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
  • Uenohara Hiroshi
    Department of Neurosurgery, National Hospital Organization Sendai Medical Center, Sendai, Miyagi, Japan
  • Tominaga Teiji
    Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan

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Abstract

<p>Objective: Endovascular treatment for complex wide-necked basilar tip aneurysms is challenging. Multiple stenting may be an option to deal with such aneurysms; however, the risk of ischemic complications is reported to be relatively high. Here, we report a case of unruptured basilar tip aneurysm treated using the intentional stent herniation technique to preserve the aneurysmal neck branches.</p><p>Case Presentation: A 65-year-old woman presented with a growing unruptured basilar tip aneurysm associated with bilateral posterior cerebral arteries (PCAs) arising from the aneurysmal dome. We intentionally selected a large-sized Neuroform Atlas stent (Stryker, Kalamazoo, MI, USA) compared to the parent artery and deployed it along the right PCA to the basilar artery. The stent was herniated into the aneurysmal dome near the origin of the left PCA, resulting in the preservation of the left PCA. Successful coil embolization was achieved with acceptable obliteration.</p><p>Conclusion: The intentional stent herniation technique may be an effective approach to treat complex wide-necked basilar tip aneurysms.</p>

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