Basilar Artery Bifurcation Aneurysm: Giant Basilar Bifurcation Aneurysm, Mass Effect, Stent-Assisted Coil Occlusion with a Single Enterprise Stent, Complete Long-Term Occlusion, Good Clinical Outcome

  • Michael KirschEmail author
Living reference work entry

Latest version View entry history



A 47-year-old man presented with an aggravation of a previously known cervical spine-degeneration related neck pain and a new headache in November 2013. MRI revealed a 26 × 19 mm, eccentric, posterior-oriented basilar bifurcation aneurysm with an ill-defined neck, occupying the interpeduncular fossa with mass effect on the crura cerebri and the midbrain but with no perianeurysmal edema or subarachnoid hemorrhage (SAH). The aneurysm was treated by endovascular coil occlusion with HydroCoils (MicroVention) and bare platinum coils, assisted by a single Enterprise stent (Cerenovus). DSA follow-up over four years confirmed the complete obliteration of the aneurysm, while the P1 segments of each posterior cerebral artery (PCA) remained patent. The main topic of this presentation is the different ways to achieve permanent occlusion in large and giant aneurysms, among them the use of HydroCoils and the merits of stent-assisted coiling.


Basilar artery bifurcation aneurysm Giant aneurysm 3D HydroCoils Stent-assisted coiling 


  1. Adeeb N, Patel AS, Griessenauer CJ, Moore JM, Foreman PM, Gupta R, Harrigan MR, Ogilvy CS, Thomas AJ. Treatment of bifurcation aneurysms using single stent-coiling with relation to aneurysm configuration: a cohort study of two academic institutions in the United States. Neurosurgery. 2016;63(Suppl 1):148. Scholar
  2. Brinjikji W, White PM, Nahser H, Wardlaw J, Sellar R, Gholkar A, Cloft HJ, Kallmes DF. HydroCoils are associated with lower angiographic recurrence rates than are bare platinum coils in treatment of “difficult-to-treat” aneurysms: a post hoc subgroup analysis of the HELPS trial. AJNR Am J Neuroradiol. 2015;36(9):1689–94. Scholar
  3. Liebig T, Henkes H, Fischer S, Weber W, Miloslavski E, Mariushi W, Brew S, Kühne D. Fibered electrolytically detachable platinum coils used for the endovascular treatment of intracranial aneurysms. Initial experiences and mid-term results in 474 aneurysms. Interv Neuroradiol. 2004;10(1):5–26.CrossRefPubMedPubMedCentralGoogle Scholar
  4. Limbucci N, Renieri L, Nappini S, Consoli A, Rosi A, Mangiafico S. Y-stent assisted coiling of bifurcation aneurysms with Enterprise stent: long-term follow-up. J Neurointerv Surg. 2016;8(2):158–62. Scholar
  5. Mühl-Benninghaus R, Simgen A, Reith W, Yilmaz U. The Barrel stent: new treatment option for stent-assisted coiling of wide-necked bifurcation aneurysms-results of a single-center study. J Neurointerv Surg. 2017;9(12):1219–22. Scholar
  6. Sağlam M, Kızılkılıç O, Anagnostakou V, Yıldız B, Koçer N, Işlak C. Geometrical characteristics after Y-stenting of the basilar bifurcation. Diagn Interv Radiol. 2015;21(6):483–7. Scholar
  7. Sheth SA, Patel NS, Ismail AF, Freeman D, Duckwiler G, Tateshima S. Treatment of wide-necked basilar tip aneurysm not amenable to Y-stenting using the PulseRider device. J Neurointerv Surg. 2016;8(9):e37. Scholar
  8. Signorelli F, Sturiale CL, La Rocca G, Albanese A, D’Argento F, Mattogno P, Puca A, Visocchi M, Marchese E, Pedicelli A. Giant basilar artery aneurysm involving the origin of bilateral posterior cerebral and superior cerebellar arteries: neck reconstruction with pCONus-assisted coiling. Acta Neurochir Suppl. 2017;124:129–34. Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Institut für Diagnostische Radiologie und Neuroradiologie, Universitätsmedizin GreifswaldGreifswaldGermany

Personalised recommendations