This is the case of a 31 years old patient.

The patient had long segment dissection of the basilar artery with a small, wide necked pseudoaneurysm on the distal segment.

As she was symptomatic, we decided to treat her.

In this situation, the only real option was to stent it and we did so.

An Enterprise stent was deployed without any difficulty.

The immediate post procedure control showed some wall smoothening as well as morphology change in the pseudoaneurysm and the parent artery.

The patient was put on dual antiplatelets and a check angiogram done after 6 months.

The was complete remodelling of the basilar artery with smooth walls and disappearance of the pseudoaneurysm. The artery had straightened and widened to some extent also.

The patient has been clinically asymptomatic since the procedure –almost 2 years now.

Fig 1: Vertebral angiogram showing the basilar artery dissection with pseudoaneurysm involving almost the entire length of the vessel

Fig 2: Post stenting vertebral angiogram showing some vessel straightening, wall smoothening and shaper change of the pseudosac; although the changes are not very prominent at this point of time

Fig 3: 6 month follow up check vertebral angiogram showing the completely remodelled artery with totally smooth wall and no visualisation of the pseudoaneurysm. The basilar artery looks somewhat larger calibre than the native artery though.