Case 2. Preoperative, intraoperative and postoperative digital subtraction angiography (DSA). Preoperative AP (first low, left) and lateral (first low, right) vertebral angiograms showing a broad-necked, large aneurysm of basilar bifurcation. Both P1s are incorporated in the aneurysm by 3-dimensional rotational angiography (second low, left). A 4×20 mm SOLITAIRE stent is deployed into the aneurysmal sac distally, and the distal basilar artery proximally in a waffle-cone manner to protect the orifices of both P1s and to support the coil mass (second low, right). Near complete obliteration of the large basilar bifurcation aneurysm is achieved with 11 coils, while sparing flows of both PCAs (third low)
|