Abstract
We describe a case in human of the combined application of endovascular stent implantation and Guglielmi detachable coil (GDC) packing in the management of a wide-necked intracranial aneurysm. A 48-year-old woman with vertebral artery aneurysm presented with subarachnoid hemorrhage. The left vertebral angiography showed a wide-necked aneurysm at the vertebral artery and the posterior inferior cerebellar artery divided just proximal to the neck. The neck of the aneurysm is 8mm long, and the dome size is maximum 13mm. Because of the size of the aneurysmal neck and aneurysm location on angiograms, it was deemed unsuitable for surgical intervention or for conventional endovascular coiling. A balloon-expandable stent was placed across the neck of the aneurysm to act as a buttress against which GDCs could be packed. Immediately after embolization, angiography showed the patency of the left vertebral and posterior inferior cerebellar artery, and the aneurysm was completely occluded. After endovascular treatment, the patients suffered no complications attributable to this procedure. In conclusion, this evolving technology may play a role in the near future as an alternative of choice in some cases of aneurysm treatment via the endovascular route especially in wide-necked aneurysm.
