Endovascular repair of a complex fusiform aneurysm of the basilar artery

(A) Pre-procedural anterior and lateral angiographic views of a large (7 x 23 mmm) fusiform basilar artery aneurysm with 2 daughter sacs, presenting with third cranial nerve compression. (B) Angiographic reconstructed image after placement of 2 overlapping intra-arterial stents, one with open-cell design and one with closed cell design, in an inverted Y configuration, each anchored proximally in a distal vertebral artery and distally in the mid-basilar artery. Arrows indicate the radiopaque stent terminus markers. The aneurysm sac continues to opacify with contrast immediately post-procedure. (C) CT angiogram image 7 months post-procedure, showing contrast filling the lumen of the stents (arrows), but not the aneurysmal sac outside the stents. (Images courtesy of Dr. Seon-Kyu Lee; Contributed by Dr. James Brorson.)