BACKGROUND: Basilar artery perforator aneurysms (BAPAs) are rare. Traditional surgical clipping and endovascular coiling have proven to be challenging. We present three patients treated with endovascular electrothrombosis and describe the characteristics of this new approach. METHODS: Three patients presented with subarachnoid hemorrhages (SAHs). Cerebral angiography identified BAPAs. Endovascular electrothrombosis was performed after obtaining informed consent. We placed the microwire into the sac of the aneurysms through the microcatheter and connected its proximal tip to the Solitaire stent detachment system. Electrothrombosis was conducted using 1.0 mA current. RESULTS: Two aneurysms were successfully occluded without treatment-related complication. The third one failed and converted to endovascular coiling using a 1.3-F microcatheter. The patient suffered brainstem infarction and finally died of severe SAH. At follow-up, the two patients were neurologically intact and angiography showed total occlusion of both aneurysms. CONCLUSION: Endovascular electrothrombosis might be a potential alternative to traditional treatment for BAPAs. Close follow-up with caution should be mandatory. More research is needed to confirm its safety and efficacy.
BACKGROUND: Basilar artery perforator aneurysms (BAPAs) are rare. Traditional surgical clipping and endovascular coiling have proven to be challenging. We present three patients treated with endovascular electrothrombosis and describe the characteristics of this new approach. METHODS: Three patients presented with subarachnoid hemorrhages (SAHs). Cerebral angiography identified BAPAs. Endovascular electrothrombosis was performed after obtaining informed consent. We placed the microwire into the sac of the aneurysms through the microcatheter and connected its proximal tip to the Solitaire stent detachment system. Electrothrombosis was conducted using 1.0 mA current. RESULTS: Two aneurysms were successfully occluded without treatment-related complication. The third one failed and converted to endovascular coiling using a 1.3-F microcatheter. The patient suffered brainstem infarction and finally died of severe SAH. At follow-up, the two patients were neurologically intact and angiography showed total occlusion of both aneurysms. CONCLUSION: Endovascular electrothrombosis might be a potential alternative to traditional treatment for BAPAs. Close follow-up with caution should be mandatory. More research is needed to confirm its safety and efficacy.
Authors: Thomas J Buell; Dale Ding; Daniel M S Raper; Ching-Jen Chen; Harry R Hixson; R Webster Crowley; Avery J Evans; Mary E Jensen; Kenneth C Liu Journal: J Neurointerv Surg Date: 2017-01-06 Impact factor: 5.836
Authors: P Bhogal; M AlMatter; V Hellstern; M Aguilar Pérez; J Lehmberg; O Ganslandt; H Bäzner; H Henkes Journal: J Clin Neurosci Date: 2019-02-04 Impact factor: 1.961
Authors: Nohra Chalouhi; Pascal Jabbour; Robert M Starke; Mario Zanaty; Stavropoula Tjoumakaris; Robert H Rosenwasser; L Fernando Gonzalez Journal: Neurosurgery Date: 2014-06 Impact factor: 4.654