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CC BY 4.0 · Indian Journal of Neurosurgery 2024; 13(02): 150-155
DOI: 10.1055/s-0043-1776020
Case Report

Failure of Reconstructive Technique to Repair a Giant Intracranial Fusiform Aneurysm of the Basilar Artery: Case Report and Literature Review in the Pediatric Population

Frank G. Solis 
1   Neurological Surgery and Endovascular Neurosurgery, Instituto de Salud del Niño, San Borja, Lima, Peru
,
Mauro Toledo 
1   Neurological Surgery and Endovascular Neurosurgery, Instituto de Salud del Niño, San Borja, Lima, Peru
,
Rosa L. Ecos 
2   Department of Vascular Neurology, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
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Abstract

Treatment of giant basilar aneurysm presents a major treatment challenge, especially in the pediatric population. Morbidity and mortality approach 80 and 30%, respectively. Both reconstructive and deconstructive techniques are associated with high rates of complete occlusion and good neurological outcomes. We report a 14-year-old male with a giant basilar trunk aneurysm treated with an endovascular approach. Clinical symptoms began following an ischemic stroke 2 weeks prior to admission. Endovascular treatment was performed through a reconstructive technique by single flow diverter device (FDD) in the basilar artery; however, this technique failed. At 1-year follow-up, without additional endovascular treatment, the mid-basilar artery and aneurysm were occluded, with vertebrobasilar flow maintained through collaterals from the right posterior communicating artery. We present a challenging management of giant basilar aneurysm in a pediatric patient experiencing a failure of FDD deployment; however, we highlight the importance of collateral flow development in progressive occlusions.

Keywords

endovascular approach - flow diverter device - giant basilar aneurysm

Authors' Contribution

F.S. and M.T. contributed to data collection, conceptualization, and manuscript drafting. RE helped in conceptualization, manuscript drafting, image preparation, and technical and manuscript review.




Publication History

Article published online:
17 October 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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