Endovascular management of basilar artery perforator aneurysm – Insights

Abstract

Basilar artery perforator aneurysm (BAPA), are rare (<1%), and with poorly defined natural history and management. BAPA was first reported by Ghogawala et al. (1996) and surgically obliterated. The management strategies are varied with 15% surgical and 52% by endovascular techniques. Notably 33% adopted conservative management. In the endovascular group direct coiling has been reported in only 3 cases. We report another case of BAPA managed by super-selective direct coil obliteration and the technical challenges associated with coiling of these aneurysms. Keywords: Basilar artery perforator aneurysm, Flow guided microcatheter, Subarachnoid hemorrhage, Super selective coiling