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Treatment of a basilar trunk perforator aneurysm with the pipeline embolization device: case report.

Publication ,  Journal Article
Chalouhi, N; Jabbour, P; Starke, RM; Zanaty, M; Tjoumakaris, S; Rosenwasser, RH; Gonzalez, LF
Published in: Neurosurgery
June 2014

BACKGROUND AND IMPORTANCE: Basilar trunk perforator (BTP) aneurysms are rare lesions that pose significant challenges to microsurgical clipping and endovascular coiling. We present the intriguing case of a ruptured BTP aneurysm that was successfully treated with the Pipeline Embolization Device (PED). CLINICAL PRESENTATION: An elderly woman presenting with subarachnoid hemorrhage was found to have a 1.5-mm aneurysm arising from the proximal portion of a thin midbasilar perforator. The decision was made to treat this aneurysm with flow diversion in an attempt to preserve the patency of the perforator and to avoid the hazards associated with parent vessel trapping. A 3 × 12-mm PED was successfully deployed in the basilar trunk across the neck of the aneurysm, causing stasis in the aneurysm, with continuous flow through the parent vessel. The procedure and postoperative course were uneventful. A follow-up angiogram 2 weeks later showed complete disappearance of the aneurysm with preservation of the patency of the perforator. At the 6-month follow-up, the patient was asymptomatic and remained neurologically intact. CONCLUSION: We present the first case of a BTP aneurysm treated with the PED. The aneurysm was successfully occluded, and the patency of the feeding vessel was preserved. In light of the limitations of coiling and the hazards associated with microsurgery and parent vessel trapping, the PED may be a valuable option for BTP aneurysms.

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Published In

Neurosurgery

DOI

EISSN

1524-4040

Publication Date

June 2014

Volume

74

Issue

6

Start / End Page

E697 / E701

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Subarachnoid Hemorrhage
  • Neurology & Neurosurgery
  • Microsurgery
  • Intracranial Aneurysm
  • Humans
  • Female
  • Embolization, Therapeutic
  • Aneurysm, Ruptured
  • Aged
 

Citation

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Chalouhi, N., Jabbour, P., Starke, R. M., Zanaty, M., Tjoumakaris, S., Rosenwasser, R. H., & Gonzalez, L. F. (2014). Treatment of a basilar trunk perforator aneurysm with the pipeline embolization device: case report. Neurosurgery, 74(6), E697–E701. https://doi.org/10.1227/NEU.0000000000000308
Chalouhi, Nohra, Pascal Jabbour, Robert M. Starke, Mario Zanaty, Stavropoula Tjoumakaris, Robert H. Rosenwasser, and L Fernando Gonzalez. “Treatment of a basilar trunk perforator aneurysm with the pipeline embolization device: case report.Neurosurgery 74, no. 6 (June 2014): E697–701. https://doi.org/10.1227/NEU.0000000000000308.
Chalouhi N, Jabbour P, Starke RM, Zanaty M, Tjoumakaris S, Rosenwasser RH, et al. Treatment of a basilar trunk perforator aneurysm with the pipeline embolization device: case report. Neurosurgery. 2014 Jun;74(6):E697–701.
Chalouhi, Nohra, et al. “Treatment of a basilar trunk perforator aneurysm with the pipeline embolization device: case report.Neurosurgery, vol. 74, no. 6, June 2014, pp. E697–701. Pubmed, doi:10.1227/NEU.0000000000000308.
Chalouhi N, Jabbour P, Starke RM, Zanaty M, Tjoumakaris S, Rosenwasser RH, Gonzalez LF. Treatment of a basilar trunk perforator aneurysm with the pipeline embolization device: case report. Neurosurgery. 2014 Jun;74(6):E697–E701.
Journal cover image

Published In

Neurosurgery

DOI

EISSN

1524-4040

Publication Date

June 2014

Volume

74

Issue

6

Start / End Page

E697 / E701

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Subarachnoid Hemorrhage
  • Neurology & Neurosurgery
  • Microsurgery
  • Intracranial Aneurysm
  • Humans
  • Female
  • Embolization, Therapeutic
  • Aneurysm, Ruptured
  • Aged