Embolization of an Aneurysm of the Basilar Artery by Balloon-Assisted Coiling and Double Microcathet?r Technique

Aneurysms of the vertebral artery are rare and represent 0.5 % to 3 % of all intracranial aneurysms and less than 20 % of those of the posterior brain circulation. Considering their surrounding regional anatomy, treatment of such aneurysms of the vertebral artery poses a major challenge to traditional neurosurgery. Endovascular techniques in the treatment of intracranially ruptured aneurysms increasingly prove their safety and effectiveness. In patients with ruptured aneurysms, endovascular techniques, such as coiling or balloon-assisted coiling, are well applicable in the acute period of subarachnoid hemorrhage, since they reduce the risk of re-bleeding after treatment. Balloon-assisted coiling (BAC) was adopted as an additional technique to endovascular treatment of complex intracranial aneurysms with wide necks and complex anatomy. The technique allows rapid placement of the required number of coils in the aneurysmal sac, within the maximum time of five minutes for the anterior circulation and up to four minutes for the basin of posterior circulation. This allows the formation of a stable structure of coils, 'a basket', which significantly facilitates the emplacement of additional threads. Thus, the standard technique of embolization with coils proves to be insufficiently effective in this type of aneurysms. We share our expirience with this technique.