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
