Intravascular balloon embolization of a large mid-basilar artery aneurysm

A patient who presented with multiple episodes of subarachnoid hemorrhage was diagnosed as having a large mid-basilar artery aneurysm that had no definable surgical neck. Balloon embolization was performed utilizing two detachable silicone balloons to occlude the mid-basilar artery and the aneurysm. The procedure was carried out with the patient fully awake and alert. One day after the procedure, the patient developed pontine and cerebellar ischemia which completely resolved after 5 days on heparin therapy. A follow-up angiogram performed immediately after the procedure and at 3 months demonstrated complete occlusion of the mid-basilar artery and the aneurysm. The patient was intact neurologically upon discharge 5 days after the embolization procedure and has since resumed his normal activities. Balloon embolization therapy may offer some advantages over surgical methods for the treatment of such therapeutically challenging aneurysms.