Recent advances in
endovascular techniques greatly improved the ability to treat complex
cerebral aneurysms. However, patients with wide-necked
cerebral aneurysms have posed a special challenge to conventional endovascular
therapy. We report a novel method of embolizing wide-necked basilar apex
aneurysms by employing a Y-configuration, double
stent technique. A 40-year-old woman with a partially thrombosed basilar apex
aneurysm transferred to our hospital after diagnosis of
subarachnoid hemorrhage. Cerebral angiography revealed a wide-necked
aneurysm which neck was incorporating the origins of both the posterior cerebral arteries. In treatment procedure, a microcatheter was inserted into the
aneurysm followed by coiling of the upper half of the dome. Next, the first
stent was deployed in the right P2 segment extending down to the mid basilar artery and the second
stent was then deployed with half of the
stent in the left P2 and the other half within the lumen of the previously placed
stent. Finally, the microcatheter was withdrawn near the neck, and the rest of the aneurysmal dome was packed by additional coils. The result was favorable. Successful coil embolization of a wide-necked bifurcation
aneurysm can be achieved by using the double stenting Y-configuration in this case. This result continues to provide highly encouraging support of this novel technique to treat a subset of complex, wide-necked
aneurysms that until recently were considered poor candidates for endovascular
therapies.