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Basilar Artery Bifurcation Aneurysm: Acute SAH, Ruptured Wide Neck Basilar Bifurcation Aneurysm, Medina and Coil Occlusion Assisted by pCONus2, Early Interruption of Antiaggregation Without Sequelae

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Abstract

A large, wide necked ruptured aneurysm of the basilar artery bifurcation was treated by endovascular Medina- (Medtronic) and coil occlusion assisted by pCONus2 (phenox). This combination of implants allowed the interruption of the blood circulation inside the aneurysm despite a neck width of 9 mm. The procedure has been carried out under dual antiaggregation with acetylsalicylic acid (ASA; Aspirin i.v., Bayer Vital) and ticagrelor (Brilique, AstraZeneca). Immediately after the treatment, a minor perfusion of the aneurysm dome was still visible, which had ceased three days later. The administration of ticagrelor had been inadvertently stopped one month after the treatment, while the administration of 100 mg ASA PO daily was continued. A thromboembolic complication did not occur. The patient, whose clinical condition was initially Hunt and Hess III, recovered significantly within two months in the hospital and having two months of rehabilitation. Angiographic follow-up three and 12 months after the treatment confirmed a stable obliteration of the aneurysm. The use of pCONus2 and Medina is the main topic of this report.

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Authors and Affiliations

  1. Institut für Nuklearmedizin und Radiologie, Klinikum Braunschweig, Braunschweig, Germany

    Harald Sahl

  2. Neuroradiologische Klinik, Neurozentrum, Klinikum Stuttgart, Stuttgart, Germany

    Hans Henkes

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  1. Harald Sahl
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  2. Hans Henkes
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Correspondence to Harald Sahl .

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Editors and Affiliations

  1. Department of Neuroradiology, Klinikum Stuttgart, Stuttgart, Baden-Württemberg, Germany

    Hans Henkes

  2. Dept. Neurosurgery & Intervent. Neurorad, Clinica Sagrada Familia , Buenos Aires, Argentina

    Pedro Lylyk

  3. Department of Neurosurgery, Klinikum Stuttgart Department of Neurosurgery, Stuttgart, Baden-Württemberg, Germany

    Oliver Ganslandt

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Sahl, H., Henkes, H. (2018). Basilar Artery Bifurcation Aneurysm: Acute SAH, Ruptured Wide Neck Basilar Bifurcation Aneurysm, Medina and Coil Occlusion Assisted by pCONus2, Early Interruption of Antiaggregation Without Sequelae. In: Henkes, H., Lylyk, P., Ganslandt, O. (eds) The Aneurysm Casebook. Springer, Cham. https://doi.org/10.1007/978-3-319-70267-4_7-1

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  • DOI: https://doi.org/10.1007/978-3-319-70267-4_7-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-70267-4

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