Article Sidebar

PDF
Date Published: 15/06/2022
Online Published: 30/12/2020
Abstract Views: 63
Views PDF: 73
DOI: https://doi.org/10.55046/vjrnm.41.208.2020
Issue
No. 41 (2020)
Section
Scientific research
How to Cite
Nguyen, V. T., Tran, A. T., Le, H. K., Nguyen, Q. A., Nguyen, T. T., Nguyen, H. A., Pham, M. T., & Vu, D. L. (2020). Basilar tip artery bifurcation aneurysm: wide-necked Incidental basilar tip artery bifurcation aneurysm - endovascular treatment with a WEB device: case report. Vietnamese Journal of Radiology and Nuclear Medicine, 41, 99-103. https://doi.org/10.55046/vjrnm.41.208.2020

Basilar tip artery bifurcation aneurysm: wide-necked Incidental basilar tip artery bifurcation aneurysm - endovascular treatment with a WEB device: case report

Dr Nguyen Van Tuan1, Dr Tran Anh Tuan2, Dr Le Hoang Kien2, Dr Nguyen Quang Anh2, Dr Nguyen Tat Thien2, Dr Nguyen Huu An2, Professor Pham Minh Thong2, Dr Vu Dang Luu2
1 The Radiology Center of Bach Mai Hospital
2 Radiology Center Bach Mai Hospital

Main Article Content

Abstract

A basilar tip artery bifurcation aneurysm was diagnosed incidentally in a 69-year-old female patient. She was a normal
her medical history. The MRI revealed a non-ruptured aneurysm with a maximum fundus diameter 4.9mm. Selective cerebral
angiography confirmed the presence of a wide-necked aneurysm with a mean transverse diameter of 5mm and a mean height of
3mm; the neck width was 4.9mm. With this complex anatomy, the multidisciplinary team recommended endovascular treatment of the aneurysm with the WEB device. The procedure was performed with dual antiplatelet therapy (75 mg aspirin PO daily 3 days and 180 mg ticagrelor PO daily 2 days prior to the intervention). Immediately after placement of the WEB device,
DSA showed complete occlusion of the aneurysm but has thromboembolic event in P3 posterior cerebral artery and no deficit.
Postoperatively the patient received dual antiplatelet therapy for 5 days and continued 75 mg aspirin PO for 2 weeks, ticagrelor
was discontinued. The patient was discharged 2 days after the intervention without any neurological symptoms. Follow-up by
MRI at 3, 6, by MRI and DSA 12 months after treatment confirmed the stable obliteration of the aneurysm without recurrence or
reperfusion. The value of the WEB device in the endovascular treatment of wide-necked basilar tip artery bifurcation aneurysms
is the main topic of this chapter.

Article Details

References

1. Fiorella D, Arthur A, Byrne J, et al. Interobserver variability in the assessment of aneurysm occlusion with the WEB aneurysm embolization system. Journal of neurointerventional surgery. 2015;7(8):591-595.
2. Pierot L, Arthur AS, Fiorella D, Spelle L. Intrasaccular Flow Disruption with WEB Device: Current Place and Results in Management of Intracranial Aneurysms. World neurosurgery. 2019;122:313-316.
3. Pierot L, Cognard C, Anxionnat R, Ricolfi F, Investigators C. Ruptured intracranial aneurysms: factors affecting the rate and outcome of endovascular treatment complications in a series of 782 patients (CLARITY study). Radiology. 2010;256(3):916-923.
4. Taschner CA, Chapot R, Costalat V, et al. Second-generation hydrogel coils for the endovascular treatment of intracranial aneurysms: a randomized controlled trial. Stroke. 2018;49(3):667-674.
5. Piotin M, Blanc R, Spelle L, et al. Stent-assisted coiling of intracranial aneurysms: clinical and angiographic results in 216 consecutive aneurysms. Stroke. 2010;41(1):110-115.
6. McDougall CG, Johnston SC, Gholkar A, et al. Bioactive versus bare platinum coils in the treatment of intracranial aneurysms: the MAPS (Matrix and Platinum Science) trial. American Journal of Neuroradiology. 2014;35(5):935-942.
7. Kallmes DF, Brinjikji W, Cekirge S, et al. Safety and efficacy of the Pipeline embolization device for treatment of intracranial aneurysms: a pooled analysis of 3 large studies. Journal of neurosurgery. 2016;127(4):775-780.
8. Brinjikji W, Murad MH, Lanzino G, Cloft HJ, Kallmes DF. Endovascular treatment of intracranial aneurysms with flow diverters: a meta-analysis. Stroke. 2013;44(2):442-447.
9. Pierot L, Costalat V, Moret J, et al. Safety and efficacy of aneurysm treatment with WEB: results of the WEBCAST study. Journal of neurosurgery. 2016;124(5):1250-1256.
10. Fiorella D, Molyneux A, Coon A, et al. Demographic, procedural and 30-day safety results from the WEB Intrasaccular Therapy Study (WEB-IT). Journal of NeuroInterventional Surgery. 2017;9(12):1191-1196.