Acute thrombosed basilar tip aneurysm

2021 ◽  
Author(s):  
Mohammed Al-Hameed, MD ◽  
Rajbir S. Pannu, MD ◽  
Kaitlin M. Zaki-Metias, MD ◽  
Kamran A. Shah, MD
Keyword(s):  
Basilar Tip Aneurysm

Tuberothalamic Infarct after Division of a Hypoplastic Posterior Communicating Artery for Clipping of a Basilar Tip Aneurysm: Case Report

Neurosurgery ◽  
1991 ◽  
Vol 28 (3) ◽  
pp. 456-459 ◽  
Author(s):  
Luca Regli ◽  
Nicolas de Tribolet
Keyword(s):  
Case Report ◽  
Clinical Observation ◽  
Significant Risk ◽  
Posterior Communicating Artery ◽  
Microsurgical Anatomy ◽  
Parent Vessel ◽  
Pterional Approach ◽  
Basilar Tip Aneurysm

Abstract The authors present a case of a tuberothalamic infarct subsequent to division of the posterior communicating artery for clipping of a high-lying aneurysm of the basilar bifurcation using the pterional approach. In view of this clinical observation and some particular aspects of the microsurgical anatomy of the perforating vessels of the posterior communicating artery, we conclude that interrupting this parent vessel carries a significant risk of infarction.

Intra-aneurysmal GDC embolization followed by intrathecal TPA administration for poor-grade basilar tip aneurysm

1997 ◽  
Vol 47 (2) ◽  
pp. 144-147 ◽  
Author(s):  
Masayuki Ezura ◽  
Akira Takahashi ◽  
Kuniaki Ogasawara ◽  
Takashi Yoshimoto
Keyword(s):  
Poor Grade ◽  
Basilar Tip Aneurysm

scholarly journals Horizontal Stent Assisted Coiling of Wide Neck Basilar Tip Aneurysm: Comparison of Two Cases

2017 ◽  
Vol 19 (3) ◽  
pp. 201 ◽  
Author(s):  
Young Jin Kim ◽  
Jae Hoon Sung ◽  
Jae Taek Hong ◽  
Sang Won Lee
Keyword(s):  
Basilar Tip Aneurysm ◽  
Wide Neck

scholarly journals Endovascular management of intracranial aneurysms during pregnancy in three cases and review of the literature

2015 ◽  
Vol 21 (6) ◽  
pp. 654-658 ◽  
Author(s):  
Peng Liu ◽  
Xianli Lv ◽  
Youxiang Li ◽  
Ming Lv
Keyword(s):  
Cesarean Section ◽  
Cerebral Aneurysms ◽  
Endovascular Coiling ◽  
Review Of The Literature ◽  
Endovascular Techniques ◽  
Healthy Baby ◽  
Unruptured Aneurysms ◽  
Gestational Week ◽  
Basilar Tip Aneurysm ◽  
Case Basis

We present three cases of cerebral aneurysms (1 unruptured; 2 ruptured) treated with endovascular techniques in pregnancies. The first ruptured case is a 28-year-old female on 20th gestational week. After the endovascular coiling, the patient suffered persistent hemiparesis and delivered a healthy baby by cesarean section. The second ruptured case is a 25-year-old female on 36th week of pregnancy. She died of aneurysm re-rupture after delivery of a healthy baby by cesarean section. The third unruptured case is a 31-year-old woman on the 26th gestational week of pregnancy who died of a giant basilar tip aneurysm after stent-assisted coiling. Ruptured aneurysm obliteration should be prioritized followed by vaginal delivery or cesarean section. The decision regarding the treatment of unruptured aneurysms should be carefully considered on a case-by-case basis. Stent-assisted coiling may be applicable to aneurysm during pregnancy.

scholarly journals Dual microcatheter technique for the treatment of a ruptured wide neck basilar tip aneurysm

2019 ◽  
pp. 116-121
Author(s):  
Rares Filep ◽  
Dorin Nicolae Gherasim ◽  
Septimiu Popescu ◽  
Botond Tokes ◽  
Lucian Marginean
Keyword(s):  
Intracranial Aneurysms ◽  
Therapeutic Option ◽  
Intraventricular Haemorrhage ◽  
Acute Onset ◽  
Alternative Methods ◽  
Neurological Deficits ◽  
Complication Rates ◽  
Unruptured Intracranial Aneurysms ◽  
Basilar Tip Aneurysm ◽  
Wide Neck

Endovascular treatment is a safe and efficient therapy for intracranial aneurysms with lower complication and mortality rates compared to surgical clipping. Wide-neck aneurysms still represent a challenge to complete and safe aneurysm occlusion in spite of techniques such as stent-assisted or balloon-assisted coiling, developed in order to achieve better occlusion rates. These techniques themselves may lead to further complications, so alternative methods such as the dual microcatheter technique were developed. This technique assumes that, via two microcatheters inserted into an aneurysm, simultaneous deployment of two coils achieves a stable coil frame without the use of adjunctive devices. The aim of this paper is to present a successfully treated basilar tip wide-neck aneurysm treated with the dual microcatheter technique.Case report. A 46-year-old male patient with acute onset of severe headache presented in the emergency room with altered state of consciousness. Non-enhanced CT scan showed subarachnoid and intraventricular haemorrhage. CT angiography revealed a wide-neck basilar tip aneurysm. Digital subtraction angiography confirmed the presence of an aneurysm with a wide, 4.9 mm neck.Dual microcatheter technique was chosen as the first treatment option, while a hypercompliant balloon was kept as backup. Two microcatheters were placed inside de aneurysm and two coils were introduced in order to form a stable framing coil mass that served as a support for further coils deployed in an alternately manner through each microcatheter. No procedural complication occurred, and the patient’s evolution was uneventful with no neurological deficits at discharge.Conclusion. The dual microcatheter technique is a safe and effective therapeutic option for wide-neck ruptured or unruptured intracranial aneurysms. Periprocedural complication rates are similar to simple coiling or balloon-assisted coiling, but lower than for stent-assisted coiling.

scholarly journals Applications of the Columbus steerable guidewire

2021 ◽  
pp. neurintsurg-2021-018120
Author(s):  
Alexander von Hessling ◽  
Tomás Reyes del Castillo ◽  
Lutz Lehmann ◽  
Justus Erasmus Roos ◽  
Grzegorz Karwacki
Keyword(s):  
Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Curvature Radius ◽  
Content Type ◽  
Complex Aneurysm ◽  
Media Player ◽  
First Case ◽  
Great Support ◽  
Basilar Tip Aneurysm ◽  
Video Player

The Columbus steerable guidewire (Rapid Medical, Israel) is a 0.014 inch guidewire with a remotely controlled deflectable tip intended for neuronavigational purposes. 1 The tip can be shaped by pulling or pushing the handle. Pulling the handle decreases the radius (from 4 mm to 2 mm) and curves the tip, while pushing the handle increases the curvature radius and straightens the tip until it bends in the opposite direction. The amount of deflection is at the discretion of the operator. Video 1 The response of the Columbus guidewire to rotational movements is inferior to that of standard wires, and the tip is very soft and malleable but brings great support when bent. We present two cases where the Columbus guidewire was used. In the first case, the Columbus enabled us to probe a posterior cerebral artery arising from a giant basilar tip aneurysm without wall contact. In the second case, the Columbus was used as a secondary wire to help cannulate the pericallosal artery in a patient with a recurrent anterior complex aneurysm; this subsequently permitted successful stent-assisted coiling of the aneurysm.Video 1

Broad Neck Basilar Tip Aneurysm Treated by Neck Plastic Intra-Aneurysmal GDC Embolisation with Protective Balloon

1997 ◽  
Vol 3 (2) ◽  
pp. 167-170 ◽  
Author(s):  
A. Takahashi ◽  
M. Ezura ◽  
T. Yoshimoto
Keyword(s):  
Basilar Artery ◽  
Balloon Catheter ◽  
Artery Aneurysm ◽  
Detachable Coil ◽  
Guglielmi Detachable Coil ◽  
Left Posterior ◽  
Basilar Artery Aneurysm ◽  
Basilar Tip Aneurysm ◽  
Aneurysmal Neck ◽  
The Stability

A 56-year-old male was found to have a basilar artery aneurysm by magnetic resonance imaging. Angiography demonstrated a broad neck basilar tip aneurysm. He refused surgical clipping but accepted intravascular embolisation. Introducing catheters were inserted into each of the bilateral vertebral arteries. A microcatheter was introduced into the aneurysm through one of the introducing catheters and a double lumen balloon catheter was introduced into the left posterior cerebral artery (PCA) through the other. The balloon was located from the left PCA to the basilar artery across the aneurysmal neck with the aid of a guidewire passed through the inner lumen of the balloon catheter. The balloon was inflated, and a Guglielmi detachable coil (GDC) was inserted until the platinum part was placed inside the aneurysm. The balloon was deflated to confirm the stability of the GDC, and then the GDC was electrically detached. This procedure was repeated until nine GDCs were successfully inserted. The aneurysm was tightly embolised despite its broad neck. Angiography comfirmed complete neck closure and stable preservation of the basilar artery and bilateral PCAs immediately, 1 week, 3 months, 6 months, and 12 months after embolisation without evidence of thrombo-embolic complications. Neck plastic intra-aneurysmal GDC embolisation using a protective balloon can be used to treat broad-neck aneurysms.

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