Intrasaccular flow disruption (WEB) of a large wide-necked basilar apex aneurysm using PulseRider-assistance

Kazim H. Narsinh, M. Travis Caton, Nausheen F. Mahmood, Randall T. Higashida, Van V. Halbach, Steven W. Hetts, Matthew R. Amans, Christopher F. Dowd, Daniel L. Cooke

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Large, wide-necked basilar apex aneurysms are difficult to treat. Microsurgical clipping can result in neurologic morbidity and mortality. Endovascular treatment often leaves remnants that need retreatment and/or stent placement with dual antiplatelet therapy. The Woven EndoBridge (WEB) is an intrasaccular flow disruption device that can be used without dual antiplatelet therapy. However, the WEB cannot typically be used in large or giant aneurysms > 10 mm because the largest diameter device is the 11 × 9.6 mm single layer sphere (SLS). We present a case in which we use a PulseRider aneurysm neck reconstruction device in the basilar artery to assist in WEB deployment within a 22 mm basilar apex aneurysm with 14 mm neck, thereby permitting aspirin monotherapy postoperatively.

Original languageEnglish
Article number101072
JournalInterdisciplinary Neurosurgery: Advanced Techniques and Case Management
StatePublished - Jun 2021
Externally publishedYes


  • Basilar apex aneurysm
  • Intrasaccular flow disruption
  • Wide-necked


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