BACKGROUND: Aneurysms of the vertebrobasilar junction (VBJ) are especially uncommon but carry a significant risk of hemorrhage and historically have been difficult to treat. In recent years, however, advancements in stent-assisted embolization have allowed better access and stabilization of complicated posterior circulation aneurysms. METHODS: We describe a novel approach in the treatment of a wide-neck aneurysm at the terminus of the left vertebral artery by a contralateral approach in a patient with ipsilateral subclavian artery occlusion. RESULTS: A complex, wide-neck aneurysm at the verterbrobasilar junction hindered by ipsilateral subclavian occlusion can successfully be treated with stent-assisted coil embolization using a contralateral approach. CONCLUSION: Contralateral U-shaped stenting offers a viable endovascular option for patients with complex aneurysms of the vertebral basilar junction but should be reserved for appropriate cases with favorable anatomy when the ipsilateral approach from the subclavian artery is unobtainable.
BACKGROUND:Aneurysms of the vertebrobasilar junction (VBJ) are especially uncommon but carry a significant risk of hemorrhage and historically have been difficult to treat. In recent years, however, advancements in stent-assisted embolization have allowed better access and stabilization of complicated posterior circulation aneurysms. METHODS: We describe a novel approach in the treatment of a wide-neck aneurysm at the terminus of the left vertebral artery by a contralateral approach in a patient with ipsilateral subclavian artery occlusion. RESULTS: A complex, wide-neck aneurysm at the verterbrobasilar junction hindered by ipsilateral subclavian occlusion can successfully be treated with stent-assisted coil embolization using a contralateral approach. CONCLUSION: Contralateral U-shaped stenting offers a viable endovascular option for patients with complex aneurysms of the vertebral basilar junction but should be reserved for appropriate cases with favorable anatomy when the ipsilateral approach from the subclavian artery is unobtainable.
Authors: DeWitte T Cross; Christopher J Moran; Colin P Derdeyn; Avi Mazumdar; Dennis Rivet; Michael M Chicoine Journal: AJNR Am J Neuroradiol Date: 2005 Nov-Dec Impact factor: 3.825
Authors: Marco A Zenteno; Luis M Murillo-Bonilla; Gerardo Guinto; Camilo R Gomez; Sergio R Martinez; Jesus Higuera-Calleja; Angel Lee; Sergio Gomez-Llata Journal: Neurosurgery Date: 2005-07 Impact factor: 4.654
Authors: G L Pride; B Welch; R Novakovic; K Rickert; J White; K Dutton-Johnson; D Samson; P Purdy Journal: J Neurointerv Surg Date: 2009-10-05 Impact factor: 5.836