Fig. 4

a 3D-DSA showed a basilar artery bifurcation aneurysm sized 5.2 mm with a spiculate on the left posterior-lateral direction. b and c Left proximal vertebral artery (VA) was dominant compared to the right VA so that we decided to select the left VA for a guiding catheter. Neither a 6-Fr nor 5-Fr guiding catheter went up through the tortuous segment of the left proximal VA (a black arrow). d We placed a 5-Fr guiding catheter in the left proximal VA and a single microcatheter (pre-shaped Excelsior SL-10 45 degree) was navigated from the VA to the right posterior cerebral artery. e We deployed a Neuroform Atlas stent (3.0 mm × 21 mm) from the right posterior cerebral artery to the basilar artery (black arrowheads). We selected the aneurysm with the same microcatheter through the stent struts and coiling was performed. f Initial angiographic results showed a neck remnant of the aneurysm