PMID- 20465934
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20121002
LR  - 20211020
IS  - 1591-0199 (Print)
IS  - 1591-0199 (Linking)
VI  - 15
IP  - 1
DP  - 2009 Mar 31
TI  - Unusual Intracranial Stent Navigation through the Circle of Willis in a Patient 
      with Recurrent Basilar Tip Aneurysm during Stent-Assisted Coiling. A Case Report.
PG  - 81-6
AB  - We describe a case of unusual Enterprise stent navigation through the Circle of 
      Willis in a patient with a basilar tip aneurysm, left internal carotid artery 
      (ICA) occlusion and previous right ICA stenting. Basilar tip aneurysms are known 
      for their therapeutic challenges, especially when the posterior cerebral arteries 
      (PCAs) are incorporated in the aneurysm neck. This becomes more technically 
      demanding if the vertebral artery does not offer a route for stent navigation. We 
      undertook stent-assisted coiling using the horizontal stenting of posterior 
      cerebral arteries via both the posterior and anterior communicating artery 
      navigation. This was necessary because the vertebral arteries were very tortuous, 
      hence not suitable for stent navigation due to their small size and stenosis at 
      their origin. Another compounding factor was the anatomy of the aneurysm neck in 
      relation to the T-shaped origin of both P1 PCAs from the basilar artery. The 
      right ICA was stented previously and the whole navigation was done through this 
      stented artery as the opposite left ICA was occluded at the bifurcation. In 
      addition, there was no visualized posterior communicating artery (PCOM) on the 
      right side, so following navigation through the anterior communicating artery 
      (ACOM) the left PCOM artery was catheterized to reach the PCAs. After horizontal 
      placement of stent, coiling was performed for the residual aneurysm. The outcome 
      of this intervention revealed successful placement of the Enterprise stent in 
      bilateral posterior cerebral arteries covering the aneurysm. Further coiling of 
      the basilar artery aneurysm was done with a good result. No complication was seen 
      in the angiography suite or later in the course of action. Horizontal stent 
      placement in wide-necked basilar aneurysms can be performed via the PCOM and ACOM 
      arteries.
FAU - Puri, A S
AU  - Puri AS
AD  - UAMS; Little Rock, USA - erenmri@yahoo.com.
FAU - Erdem, E
AU  - Erdem E
LA  - eng
PT  - Journal Article
DEP - 20090415
PL  - United States
TA  - Interv Neuroradiol
JT  - Interventional neuroradiology : journal of peritherapeutic neuroradiology, 
      surgical procedures and related neurosciences
JID - 9602695
PMC - PMC3306154
EDAT- 2009/03/31 00:00
MHDA- 2009/03/31 00:01
PMCR- 2010/03/01
CRDT- 2010/05/15 06:00
PHST- 2008/11/29 00:00 [received]
PHST- 2008/12/07 00:00 [accepted]
PHST- 2010/05/15 06:00 [entrez]
PHST- 2009/03/31 00:00 [pubmed]
PHST- 2009/03/31 00:01 [medline]
PHST- 2010/03/01 00:00 [pmc-release]
AID - IN.v15.i1.p81 [pii]
AID - 10.1177/159101990901500113 [doi]
PST - ppublish
SO  - Interv Neuroradiol. 2009 Mar 31;15(1):81-6. doi: 10.1177/159101990901500113. Epub 
      2009 Apr 15.