P23 Stent in stent for the treatment of giant basilar aneurysm

• Published in: Journal of neurointerventional surgery Vol. 14; no. Suppl 2; p. A18
• Main Authors: Nedeljkovic, Z, Vukasinovic, I
• Format: Journal Article
• Language: English
• Published: BMA House, Tavistock Square, London, WC1H 9JR BMJ Publishing Group Ltd 01.09.2022; BMJ Publishing Group LTD
• Subjects: 14th Congress of the European Society of Minimally Invasive Neurological Therapy 2022 Meeting Abstracts; Aneurysms; Stents
• ISSN: 1759-8478; 1759-8486
• DOI: 10.1136/neurintsurg-2022-ESMINT.45

Basilar artery aneurysms account for 7–8% of all intracranial aneurysms. They are often wide necked, thereby posing a great challenge in their treatment. Endovascular treatment represents the main method of treatment using stents, flowdiverters,ballons and detachable coils. We present a patient with partially thrombosed basilar tip aneurysm, which we treated using the stent-in-stent technique. A 35 years old female presented with dizziness and gait disturbances. Brain MRI with MR angiography was performed and has shown a giant partially thrombosed basilar tip aneurysm with brainstem compression.On admission the patient was adynamic, bradypsyhic, she was walking with aid, She complained of double vision, nystagmus and unability to swallow solid food. Due to clinical deteoration, brain CT scan was performed and has shown the presence of hydrocephalus, thus the VP shunt placement procedure was performed. Endovascular treatment was performed several days later. Patient was prepared with dual antiplatelet therapy (Aspirin and Plavix) for 3 days before the intervention. VerifyNow has shown that the patient was Plavix hyperresponder (PRU 7).DSA has shown giant basilar tip aneurysm. In the further course of the procedure jailing technique was performed, followed by stent in stent technique with LVIS and LVIS junior stents. Postprocedural course went unenventful. 6 months clinical follow-up showed complete remission of almost all symptoms with complete occlusion of the aneurysm without neuroradiological or neurological complications.Our case report has shown that stent-in-stent technique, used as homemade flowdiverter, can be a suitable, safe and technicaly feasible alternative treatment option for the basilar tip aneurysms. However further larger studies are required to assess long term complications, such as aneurysmal recanalisation, in these patients.