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Endovascular treatment of complex vertebrobasilar junction aneurysms: A report of two cases
INTRODUCTION: Vertebrobasilar junction (VBJ) aneurysms are uncommon posterior circulation aneurysms. The treatment of VBJ aneurysms is challenging and in most cases, endovascular management is preferred over neurosurgery. PRESENTATION OF CASE: We describe two patients with VBJ aneurysms who underwen...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7452632/ https://www.ncbi.nlm.nih.gov/pubmed/32836212 http://dx.doi.org/10.1016/j.ijscr.2020.08.003 |
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author | Phuyal, Subash Paudel, Raju Agrawal, Pooja Neupane, Nirmal Prasad Lamsal, Ritesh |
author_facet | Phuyal, Subash Paudel, Raju Agrawal, Pooja Neupane, Nirmal Prasad Lamsal, Ritesh |
author_sort | Phuyal, Subash |
collection | PubMed |
description | INTRODUCTION: Vertebrobasilar junction (VBJ) aneurysms are uncommon posterior circulation aneurysms. The treatment of VBJ aneurysms is challenging and in most cases, endovascular management is preferred over neurosurgery. PRESENTATION OF CASE: We describe two patients with VBJ aneurysms who underwent successful neuro-interventional procedures. The first patient had concomitant basilar fenestration and was treated with balloon-assisted coiling. The second patient had difficult vascular anatomy and an anterior inferior cerebellar artery-posterior inferior cerebellar artery variant arising from the neck of the aneurysm. Braided stent-assisted coiling was done with transradial access. Both patients had a good neurologic recovery. DISCUSSION: Endovascular management of VBJ aneurysms is often complicated by anatomic difficulties like basilar fenestration, tortuosity of proximal vessels, atheromatous changes, and vascular stenosis. We achieved good post-procedure outcomes in both the patients. Optimal management of complex VBJ aneurysms often requires some modification to the usual interventional technique. CONCLUSION: VBJ aneurysms are generally treated with endovascular techniques. The transradial access, although rarely used by neurointerventionalists, has some distinct advantages over the transfemoral access, especially when dealing with right-sided VBJ aneurysms with marked tortuosity of proximal great vessels. |
format | Online Article Text |
id | pubmed-7452632 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-74526322020-09-02 Endovascular treatment of complex vertebrobasilar junction aneurysms: A report of two cases Phuyal, Subash Paudel, Raju Agrawal, Pooja Neupane, Nirmal Prasad Lamsal, Ritesh Int J Surg Case Rep Article INTRODUCTION: Vertebrobasilar junction (VBJ) aneurysms are uncommon posterior circulation aneurysms. The treatment of VBJ aneurysms is challenging and in most cases, endovascular management is preferred over neurosurgery. PRESENTATION OF CASE: We describe two patients with VBJ aneurysms who underwent successful neuro-interventional procedures. The first patient had concomitant basilar fenestration and was treated with balloon-assisted coiling. The second patient had difficult vascular anatomy and an anterior inferior cerebellar artery-posterior inferior cerebellar artery variant arising from the neck of the aneurysm. Braided stent-assisted coiling was done with transradial access. Both patients had a good neurologic recovery. DISCUSSION: Endovascular management of VBJ aneurysms is often complicated by anatomic difficulties like basilar fenestration, tortuosity of proximal vessels, atheromatous changes, and vascular stenosis. We achieved good post-procedure outcomes in both the patients. Optimal management of complex VBJ aneurysms often requires some modification to the usual interventional technique. CONCLUSION: VBJ aneurysms are generally treated with endovascular techniques. The transradial access, although rarely used by neurointerventionalists, has some distinct advantages over the transfemoral access, especially when dealing with right-sided VBJ aneurysms with marked tortuosity of proximal great vessels. Elsevier 2020-08-19 /pmc/articles/PMC7452632/ /pubmed/32836212 http://dx.doi.org/10.1016/j.ijscr.2020.08.003 Text en © 2020 Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Article Phuyal, Subash Paudel, Raju Agrawal, Pooja Neupane, Nirmal Prasad Lamsal, Ritesh Endovascular treatment of complex vertebrobasilar junction aneurysms: A report of two cases |
title | Endovascular treatment of complex vertebrobasilar junction aneurysms: A report of two cases |
title_full | Endovascular treatment of complex vertebrobasilar junction aneurysms: A report of two cases |
title_fullStr | Endovascular treatment of complex vertebrobasilar junction aneurysms: A report of two cases |
title_full_unstemmed | Endovascular treatment of complex vertebrobasilar junction aneurysms: A report of two cases |
title_short | Endovascular treatment of complex vertebrobasilar junction aneurysms: A report of two cases |
title_sort | endovascular treatment of complex vertebrobasilar junction aneurysms: a report of two cases |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7452632/ https://www.ncbi.nlm.nih.gov/pubmed/32836212 http://dx.doi.org/10.1016/j.ijscr.2020.08.003 |
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