Giant Vertebrobasilar Junction Aneurysm Treated with Proximal Occlusion of Parent Artery Followed by Coil Embolization of Partially Thrombosed Aneurysm: A Case Report.

Kim,  Bum Soo; Ihn,  Yon Kwon; Ahn,  Kook Jin; Won,  Yoo Dong; Song,  Ha Hun

Case Report

Neurointervention 2007;2(1):50-55.

Bum Soo Kim, Yon Kwon Ihn, Kook Jin Ahn, Yoo Dong Won, Ha Hun Song

¹Department of Radiology, The Catholic University of Korea, Korea. bumrad@catholic.ac.kr
²Department of Radiology, Halla General Hospital, Korea.

Abstract

In the case of giant vertebrobasilar junction aneurysm with an outflow directly draining into the basilar artery, trapping of ipsilateral vertebral artery is technically challenging. Endosaccular coil embolization may be an option, but it may aggravate symptoms due to mass effect or aneurysmal regrowth after coil compaction. Occlusion of the ipsilateral vertebral artery proximal to the aneurysm may be another option. However, complete thrombosis should be eventually achieved to prevent symptom progression from the retrograde flow or mass effect by the partial thrombosis within the aneurysm. The authors describe a case of giant vertebrobasilar aneurysm initially treated with proximal occlusion. As the aneurysm getting partial thrombosis, the bulbar compression symptom was slowly aggravated. We performed endosaccular coiling of small remaining sac 2 months later, which resulted in complete resolution of compression symptom.

Key Words: Giant aneurysm; Vertebrobasilar junction; Aneurysm coiling