Super-selective coil embolization of a basilar perforator artery aneurysm previously treated by the stent-in-stent technique, using an extremely soft bare coil delivered through a one-marker microcatheter

Chau, Yves; Sachet, M.; Sédat, Jacques

doi:10.1177/1591019917720807

Cited by 7 publications

(4 citation statements)

References 18 publications

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“…Among the reported cases of BAPA treated with overlapping stents, 6 patients had no complications of embolization. Stenting is technically easier than coil embolization because it does not require a microcatheter to pass through the perforator[ 6 , 15 , 19 , 26 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

An unusual etiology of subarachnoid hemorrhage, basilar artery perforator aneurysms, in Macao: Three case reports and review of literature

Man,

Pan,

2024

World J Clin Cases

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BACKGROUND Subarachnoid hemorrhage is a severe neurological condition that requires prompt and appropriate treatment to prevent complications. Aneurysms are the most common cause of spontaneous subarachnoid hemorrhage. Conversely, basilar artery perforator aneurysms (BAPAs) are a rare etiology. There is no consensus on the optimal management of ruptured BAPAs in the acute setting. CASE SUMMARY We present a case series of 3 patients with ruptured BAPAs who were treated at our institution. Two patients had a modified Fisher grade of I, and one had a grade of IV on initial presentation. The aneurysms were detected by computed tomography angiography in two cases and conventional angiography in one case. The 3 patients underwent endovascular treatment with Guglielmi detachable coils. Post-treatment, the patients had good clinical outcomes, and follow-up brain computed tomography scans showed reduced subarachnoid hemorrhage without any new hemorrhage. However, one patient experienced a cerebral infarction 2 months later and eventually succumbed to the condition. The other 2 patients showed progressive recovery, and no aneurysm recurrence was observed at the 2-year follow-up. CONCLUSION Endovascular treatment may be a preferable approach for managing ruptured BAPAs compared with surgical intervention or conservative management. Early detection and prompt treatment is important to achieve favorable patient outcomes.

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Section: Discussionmentioning

confidence: 99%

An unusual etiology of subarachnoid hemorrhage, basilar artery perforator aneurysms, in Macao: Three case reports and review of literature

Man,

Pan,

2024

World J Clin Cases

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“…Overlapping stents and flow diverter are also prospective alternatives to BAPAs. 11 Their curative value is evident for huge aneurysms; however, for tiny aneurysms, its value remains to be demonstrated. Bhogal et al reported the application of flow diverter in six patents with BAPAs, five of whom had a good outcome (mRS < 2).…”

Section: Discussionmentioning

confidence: 99%

Endovascular electrothrombosis: A promising alternative for basilar artery perforator aneurysm treatment

Zhao

Fang

et al. 2021

Interv Neuroradiol

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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.

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“…It can be readily detached in comparison with other coils when adopting a one-marker MC. 4 , 8) Regarding the Barricade and Target, when attaching a detachment system of the coil, it is necessary to transiently remove a rotating hemostatic valve (RHV) connected to an MC due to the length of the delivery wire. 3 , 5) One previous study reported that blood regurgitation into an MC related to RHV removal upon detachment when using a Barricade led to thrombus formation as a complication.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Recurrent Aneurysm of the Internal Carotid Artery-poster Communicating Artery Using the Marathon Microcatheter: A Case Report

Uyama

Takeuchi

Konishi

et al. 2020

JNET

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We report the case of an aneurysm of the recurrent internal carotid artery (ICA)-posterior communicating artery (PCoA) treated using a liquid embolic delivery microcatheter (MC; Marathon). Case Presentation: A 66-year-old female previously presented with subarachnoid hemorrhage, which had been treated using coil embolization for a ruptured ICA-PCoA aneurysm. She was referred to our hospital because the aneurysm recurred 13 years after treatment. Angiography revealed a de novo lobulated aneurysm at the ICA-PCoA bifurcation with a relatively thickened PCoA branching from the neck of the aneurysm. We performed coil embolization after stent placement with the Neuroform Atlas in the range of the ICA terminus and the PCoA. However, the coils were unequally distributed and it was necessary to navigate the MC to the aneurysm within the stent through the PCoA. We successfully approached the aneurysm using the Marathon. We additionally inserted six ED coils into the aneurysm and achieved favorable embolization. Conclusion:The Marathon is useful for passage of a stent deployed in a small-caliber artery.

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Super-selective coil embolization of a basilar perforator artery aneurysm previously treated by the stent-in-stent technique, using an extremely soft bare coil delivered through a one-marker microcatheter

Cited by 7 publications

References 18 publications

An unusual etiology of subarachnoid hemorrhage, basilar artery perforator aneurysms, in Macao: Three case reports and review of literature

An unusual etiology of subarachnoid hemorrhage, basilar artery perforator aneurysms, in Macao: Three case reports and review of literature

Endovascular electrothrombosis: A promising alternative for basilar artery perforator aneurysm treatment

Treatment of Recurrent Aneurysm of the Internal Carotid Artery-poster Communicating Artery Using the Marathon Microcatheter: A Case Report

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