PT  - JOURNAL ARTICLE
AU  - Joseph Morrison
AU  - Matthew David Alexander
AU  - Christopher F Dowd
AU  - Daniel L Cooke
TI  - Flanking the fenestration: circumferential limb-to-limb stent-assisted coiling of a basilar artery fenestration aneurysm
AID  - 10.1136/bcr-2017-013252
DP  - 2017 Nov 07
TA  - BMJ Case Reports
PG  - bcr-2017-013252
VI  - 2017
4099  - http://casereports.bmj.com/content/2017/bcr-2017-013252.short
4100  - http://casereports.bmj.com/content/2017/bcr-2017-013252.full
AB  - A man aged 61 years with a history of a ruptured basilar fenestration aneurysm underwent unassisted coiling in 1997 and repeat intervention for a recurrence at the aneurysm mouth in 2011. At repeat intervention, the decision was made to intentionally leave some filling at the base to preserve the parent vessels. Stent-assisted coil embolization, although technically feasible, was not pursued given the relative risks of the procedure. In 2017, the patient returned for repeat surveillance and further coil compaction was found at the aneurysm base. With the advent of more compliant woven stents deliverable through 0.017 microcatheters, stent-assisted coiling was possible. This case demonstrates hereto unseen agility afforded by novel low-profile stents allowing a circumferential approach to a basilar artery fenestration aneurysm and resultant limb-to-limb stent-assisted coiling. Techniques described here may be extended to more common anatomic variants that require stent-assisted coiling.