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Review
. 2018 Feb;24(1):22-28.
doi: 10.1177/1591019917734531. Epub 2017 Oct 12.

Should we treat aneurysms in perforator arteries from the basilar trunk? Review of 49 cases published in the literature and presentation of three personal cases

Yves Chau  1 , Marina Sachet  1 , Jacques Sédat  1
Affiliations
Review

Should we treat aneurysms in perforator arteries from the basilar trunk? Review of 49 cases published in the literature and presentation of three personal cases

Yves Chau et al. Interv Neuroradiol. 2018 Feb.

Abstract

Basilar trunk perforator artery aneurysms are rare. Their diagnosis and treatment are difficult, controversial, and challenging. Analysis of 52 cases (49 documented in the literature and three personal cases) clearly shows a re-bleeding rate of 15% in patients whose aneurysm has not been occluded and 0% in treated patients ( p < 0.05). The most effective treatment, and the one that presents the least complication, is double-stenting across the basilar trunk.

Keywords: Perforator aneurysm; basilar trunk; stent.

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Figures

Figure 1.
Figure 1.
(a) Arteriography (anteroposterior view) two months after subarachnoid haemorrhage (SAH), a 2.5 mm distal one-third perforator aneurysm (arrow). (b) Three-dimensional angiography two months after SAH. (c) Pre-embolisation angiogram: significant decrease of the aneurysm.
Figure 2.
Figure 2.
(a) Arteriography (anteroposterior view) one year later: total disappearance of the aneurysm (arrow). (b) Three-dimensional angiography one year later.
Figure 3.
Figure 3.
(a) Lateral view of the initial angiography showed a 1.8 mm distal perforator aneurysm (arrow). (b) Three-dimensional angiography (arrow).
Figure 4.
Figure 4.
(a) Three-dimensional angiography at day one. (b) Anteroposterior view after stent-in-stent technique: no opacification of the aneurysm.
Figure 5.
Figure 5.
(a) Lateral view (subtracted) at ninth day showed a 2.5 mm aneurysmal repermeabilisation. (b) A lateral view (non-subtracted). (c) Three-dimensional reconstruction. (d) Two coils were delivered through the mesh of the two stents.
See this image and copyright information in PMC

References

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