Stent-Assisted Coil Embolization of a True Posterior Communicating Artery Aneurysm: A Case Report

TL;DR

A 74-year-old woman with a rare brain aneurysm was successfully treated using a stent and coils, preserving artery function and avoiding surgery.

Contribution

Demonstrates stent-assisted coiling as an effective treatment for true posterior communicating artery aneurysms.

Findings

Stent-assisted coiling achieved complete aneurysm occlusion with preserved artery patency.

The patient had no neurological deficits and was discharged with a modified Rankin Scale score of 0.

Six-month follow-up confirmed durable occlusion without recanalization.

Abstract

True aneurysms arising from the posterior communicating artery (PCoA) are rare. Although most reported cases have been managed microsurgically, advances in low-profile stents and microcatheters have expanded endovascular options while preserving PCoA flow. A 74-year-old woman was incidentally diagnosed with an 8-mm unruptured true PCoA aneurysm on a fetal-type left PCoA. The broad neck and medial projection made microsurgical clipping less suitable. A Neuroform Atlas stent was delivered by advancing a microcatheter from the internal carotid artery into the PCoA. The stent was deployed with both ends anchored within the PCoA, followed by coil embolization using the jailing technique. Complete aneurysm occlusion was achieved with preserved PCoA patency. The patient had no neurological deficits and was discharged on postoperative day 7 with a modified Rankin Scale score of 0. Six-month follow-up imaging confirmed durable occlusion without recanalization. Stent-assisted coiling with a low-profile intracranial stent can be an effective reconstructive option for wide-neck true PCoA aneurysms while maintaining PCoA flow. Long-term imaging follow-up is warranted.

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