Overlapping Stent Placement with Coil Embolization for Ruptured Growing Basilar Artery Dissecting Aneurysm: A Case Report

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Objective: We report a patient in whom overlapping stent placement with coil embolization was useful for treating a ruptured basilar artery (BA) dissecting aneurysm with rapid enlargement.

Case Presentation: A 50-year-old female presented with subarachnoid hemorrhage (SAH). On evaluation, a fusiform dilatation of the BA was noted, suggesting a dissecting aneurysm. Rapid enlargement of the aneurysmal dilatation was observed between days 9 and 16. On day 18, overlapping stent placement was performed in the dilated BA, and the aneurysmal dilatation was roughly embolized using coils. No neurologic deficit was observed in the postoperatively, and the patient was discharged with modified Rankin Scale (mRS) 0. Follow-up DSA at 8 months after the procedure showed the complete obliteration of the aneurysm with the remodeling of the BA. During the 29-month follow-up, there has been no recurrence.

Conclusion: Overlapping stent placement for a dissecting BA aneurysm was effective treatment leading to favorable vascular remodeling.