AUTHOR=Wang Hao , Zhang Jingyu , Yang Huajiang , Zeng Shi , Guo Tengyun , Xu Lunshan , Yang Donghong TITLE=Flow-diverter stents combined with flow-T stenting-assisted coiling for the treatment of a large basilar apex aneurysm: a case report with a 9-month follow-up JOURNAL=Frontiers in Neurology VOLUME=14 YEAR=2024 URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1247549 DOI=10.3389/fneur.2023.1247549 ISSN=1664-2295 ABSTRACT=Background

Endovascular or surgical treatment of wide-neck, large basilar apex aneurysms is challenging. We present a novel concept for the treatment of complex basilar apex aneurysms using flow-diverter devices combined with the flow-T stenting-assisted coiling technique. Assess the efficacy and safety profile of the technique in this complex aneurysm.

Case description

A patient with multiple unruptured intracranial aneurysms underwent staged treatment. A large basilar apex aneurysm was treated with a flow-diverter stent combined with a flow-T stenting-assisted coiling technique in the first stage, and a giant supraclinoid aneurysm was treated with a flow-diverter stent applied in the second stage. Clinical presentations, technical details, intra- and perioperative complications, and clinical and angiographic outcomes were recorded, with a 9-month follow-up.

Results

The patient achieved full neurologic recovery postoperatively. Cerebral angiography performed postoperatively showed revascularization, good laminar flow, and no in-stent or adjacent stenosis.

Conclusion

Flow-diverter stents combined with flow-T stenting-assisted coiling for the treatment of giant basilar apex aneurysms is a feasible technique with efficacy demonstrated at a 9-month follow-up. Staged endovascular treatment of multiple intracranial aneurysms may be a safe and viable option.