Basilar Artery Bifurcation Aneurysm: Incidental Flow-Related Wide-Necked Basilar Bifurcation Aneurysm in a Ruptured Arteriovenous Malformation, Treated with PulseRider-Assisted Coil Occlusion with Angiographic Exclusion of the Aneurysm and Good Clinical Outcome

  • Ivan Lylyk
  • Rodolfo Nella Castro
  • Rene Viso
  • Pedro LylykEmail author
Living reference work entry


Endovascular treatment of wide-necked bifurcation aneurysms tends to be challenging due to the complex anatomy of the bifurcation and the need to preserve the efferent branches. If coil occlusion is deemed to be the best treatment strategy, this procedure may require the use of ancillary devices such as a balloon or stent. A particularly tricky procedure is remodeling the neck with stents placed in a “Y” configuration at the bifurcation. Fortunately, new devices have been developed to address this issue. These devices, which support the coil cast without requiring the distal branches to be catheterized, have produced good results when used in endovascular treatment of basilar bifurcation aneurysms. In this chapter, we present the case of a 54-year-old male patient with a ruptured arteriovenous malformation (AVM) and multiple brain aneurysms. A basilar bifurcation aneurysm was treated using a PulseRider device. This led to the aneurysm being completely occluded and remaining so at follow-up. The treatment of wide-necked bifurcation aneurysms using the PulseRider device is the main topic of this chapter.


Basilar artery bifurcation PulseRider Stent-assisted coil occlusion Wide-necked aneurysm Arteriovenous malformation 


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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Ivan Lylyk
    • 1
  • Rodolfo Nella Castro
    • 1
  • Rene Viso
    • 1
  • Pedro Lylyk
    • 1
    Email author
  1. 1.Clinica La Sagrada Familia, ENERIBuenos AiresArgentina

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