Basilar Artery Trunk Aneurysm: A Complex Aneurysm at a Basilar Artery Trunk Fenestration, Treated with Comaneci-Assisted Coil Occlusion

  • Stanimir SirakovEmail author
  • Alexander Sirakov
Living reference work entry


A 57-year-old female patient presented to our hospital with a 3-month history of severe recurrent headaches. At the time of admission, the patient was neurologically intact with a Glasgow Coma Scale score of 15. There was no evidence of focal neurologic deficit or cranial nerve lesions, but there was subtle neck stiffness. Computed tomography angiography (CTA) demonstrated a saccular aneurysm associated with a fenestration of the basilar artery (BA) trunk with no evidence of subarachnoid hemorrhage (SAH). The wide-necked aneurysm was treated by endovascular coil occlusion assisted by a temporary neck-bridging device (Comaneci). This is a new option for the endovascular treatment of wide-necked aneurysms including those associated with a fenestration. The patient tolerated the procedure well, and there was no resulting neurological deficit. Follow-up DSA at 3 months confirmed the complete occlusion of the aneurysm. The use of the Comaneci as an assist device for coil occlusion in aneurysms associated with a fenestration of the parent artery is the main topic of this chapter.


Basilar artery Fenestration Comaneci device Temporary stent-assisted coiling Wide-necked aneurysm 


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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.NeuroradiologyUniversity Hospital St. Ivan RilskiSofiaBulgaria

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