J Korean Neurosurg Soc.  2012 Jan;51(1):62-65. 10.3340/jkns.2012.51.1.62.

Endovascular Treatment of a Large Partially Thrombosed Basilar Tip Aneurysm

  • 1Department of Neurosurgery, Dankook University College of Medicine, Cheonan, Korea. kimyj@dku.edu


Despite the remarkable developments in neurosurgical and neuro-interventional procedures, the optimal treatment for large or giant partially thrombosed aneurysms with a mass effect remains controversial. The authors report a case of a partially thrombosed aneurysm with a mass effect, which was successfully treated by stent-assisted coil embolization. A 41-year-old man presented with headache. Brain computed tomography depicted an 18x18 mm sized thrombosed aneurysm in the interpeducular cistern. More than 80% of the aneurysm volume was filled with thrombus and the canalized portion beyond its neck measured 6.8x5.6 mm by diagnostic cerebral angiography. Stent-assisted endovascular coiling was performed on the canalized sac and the aneurysm was completely obliterated. Furthermore, most of the thrombosed aneurysm disappeared in the interpeduncular cistern was clearly visualized follow-up brain magnetic resonance imaging conducted at 21 months. The authors report a case of selective coiling of a large, partially thrombosed basilar tip aneurysm.


Endovascular treatment; Thrombosed aneurysm

MeSH Terms

Cerebral Angiography
Follow-Up Studies
Magnetic Resonance Imaging


  • Fig. 1 The brain computed tomography revealed an 18×18 mm sized mass compressing the midbrain.

  • Fig. 2 The cerebral angiography shows that the patent portion of the aneurysm has an inverted triangular shape and measured 6.8×5.6 mm. A : Anteropostrior view. B : Lateral view.

  • Fig. 3 Cerebral angiographs during and after the procedure. A : During procedure. A 3.5×20 mm stent is being deployed from the right PCA to the basilar artery, because the left PCA, which is supplied from the left internal carotid artery via PCom, is not visualized by vertebral angiography. B : After procedure. The aneurysm is found to have been completely obliterated by immediate post-operative angiography and the right PCA is patent. The coils pushed into the thrombosed portion are also visualized. PCA : posterior cerebral artery, PCom : posterior communicating.

  • Fig. 4 Postoperative brain MRI. A : On postoperative day 1, brain MRI shows a 18×18 mm sized mass compressing the adjacent structures in the interpeduncular cistern. B : At 21 months postoperatively, most of the thrombosed aneurysm has disappeared and the interpeduncular cistern is clearly observed. MRI : magnetic resonance imaging.

  • Fig. 5 Postoperative angiography. A (anteroposterior view) and B (lateral view) : After procedure, the shape of coiled mass is shown in cerebral angiography. C (anteropostrior view) and D (lateral view) : On post operative month 21, cerebral angiography shows the compaction of coiled mass from thrombosed portion toward the neck by shrinkage of aneurysm.

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