An Interventional Quandary—Clipping vs Coiling vs STA-MCA Bypass in a Ruptured Basilar Tip Aneurysm with Bilateral ICA Stenosis: A Rare Case Report and a Comprehensive Review

Our primary goal is to report a detailed case outlining the clinical and radiological characteristics of an extremely rare condition: bilateral internal carotid artery (ICA) stenosis with ruptured basilar tip aneurysm, and bilateral posterior cerebral arteries (PCAs) arising from the sac, treatment...

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Main Authors: Rahul Sharma, Anand Katkar, Ashok Bhanage, Chintan Popat
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-11-01
Series:Medical Journal of Dr. D.Y. Patil Vidyapeeth
Subjects:
Online Access:https://journals.lww.com/10.4103/mjdrdypu.mjdrdypu_76_24
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author Rahul Sharma
Anand Katkar
Ashok Bhanage
Chintan Popat
author_facet Rahul Sharma
Anand Katkar
Ashok Bhanage
Chintan Popat
author_sort Rahul Sharma
collection DOAJ
description Our primary goal is to report a detailed case outlining the clinical and radiological characteristics of an extremely rare condition: bilateral internal carotid artery (ICA) stenosis with ruptured basilar tip aneurysm, and bilateral posterior cerebral arteries (PCAs) arising from the sac, treatment options, as well as its outcome. We searched the PUBMED database from 1980 to 2023 for similar case reports. Among seven similar cases found, two were conservatively managed, focusing on reducing intracranial pressure (ICP). One out of two survived, while one ended in fatality. In the other five cases, interventions (endovascular in four/STA-MCA (superficial temporal artery–middle cerebral artery) bypass in one) were pursued, resulting in significant recovery and discharge. Dealing with such complex cases with uncommon pathoanatomy poses treatment challenges due to their hemodynamics and the risk of collateral flow cessation despite multiple available treatment options.
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language English
publishDate 2024-11-01
publisher Wolters Kluwer Medknow Publications
record_format Article
series Medical Journal of Dr. D.Y. Patil Vidyapeeth
spelling doaj-art-b7953fb9ef2f48bd804b4b9e306039112025-08-20T02:20:51ZengWolters Kluwer Medknow PublicationsMedical Journal of Dr. D.Y. Patil Vidyapeeth2589-83022589-83102024-11-011761267127010.4103/mjdrdypu.mjdrdypu_76_24An Interventional Quandary—Clipping vs Coiling vs STA-MCA Bypass in a Ruptured Basilar Tip Aneurysm with Bilateral ICA Stenosis: A Rare Case Report and a Comprehensive ReviewRahul SharmaAnand KatkarAshok BhanageChintan PopatOur primary goal is to report a detailed case outlining the clinical and radiological characteristics of an extremely rare condition: bilateral internal carotid artery (ICA) stenosis with ruptured basilar tip aneurysm, and bilateral posterior cerebral arteries (PCAs) arising from the sac, treatment options, as well as its outcome. We searched the PUBMED database from 1980 to 2023 for similar case reports. Among seven similar cases found, two were conservatively managed, focusing on reducing intracranial pressure (ICP). One out of two survived, while one ended in fatality. In the other five cases, interventions (endovascular in four/STA-MCA (superficial temporal artery–middle cerebral artery) bypass in one) were pursued, resulting in significant recovery and discharge. Dealing with such complex cases with uncommon pathoanatomy poses treatment challenges due to their hemodynamics and the risk of collateral flow cessation despite multiple available treatment options.https://journals.lww.com/10.4103/mjdrdypu.mjdrdypu_76_24basilar tip aneurysmbilateral internal carotid stenosisruptured aneurysm
spellingShingle Rahul Sharma
Anand Katkar
Ashok Bhanage
Chintan Popat
An Interventional Quandary—Clipping vs Coiling vs STA-MCA Bypass in a Ruptured Basilar Tip Aneurysm with Bilateral ICA Stenosis: A Rare Case Report and a Comprehensive Review
Medical Journal of Dr. D.Y. Patil Vidyapeeth
basilar tip aneurysm
bilateral internal carotid stenosis
ruptured aneurysm
title An Interventional Quandary—Clipping vs Coiling vs STA-MCA Bypass in a Ruptured Basilar Tip Aneurysm with Bilateral ICA Stenosis: A Rare Case Report and a Comprehensive Review
title_full An Interventional Quandary—Clipping vs Coiling vs STA-MCA Bypass in a Ruptured Basilar Tip Aneurysm with Bilateral ICA Stenosis: A Rare Case Report and a Comprehensive Review
title_fullStr An Interventional Quandary—Clipping vs Coiling vs STA-MCA Bypass in a Ruptured Basilar Tip Aneurysm with Bilateral ICA Stenosis: A Rare Case Report and a Comprehensive Review
title_full_unstemmed An Interventional Quandary—Clipping vs Coiling vs STA-MCA Bypass in a Ruptured Basilar Tip Aneurysm with Bilateral ICA Stenosis: A Rare Case Report and a Comprehensive Review
title_short An Interventional Quandary—Clipping vs Coiling vs STA-MCA Bypass in a Ruptured Basilar Tip Aneurysm with Bilateral ICA Stenosis: A Rare Case Report and a Comprehensive Review
title_sort interventional quandary clipping vs coiling vs sta mca bypass in a ruptured basilar tip aneurysm with bilateral ica stenosis a rare case report and a comprehensive review
topic basilar tip aneurysm
bilateral internal carotid stenosis
ruptured aneurysm
url https://journals.lww.com/10.4103/mjdrdypu.mjdrdypu_76_24
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