The ’bendy' basilar: progressive aneurysm tilting and arterial deformation can be a delayed outcome after coiling of large basilar apex aneurysms

Background Morphological changes in the basilar artery and the artery-aneurysm relationship following coiling of large basilar apex aneurysms may induce morbidity. Methods The basilar artery radius-of-curvature was measured along its center line on volumetrically reconstructed images formatted along the plane of curvature. The aneurysm-tilt-angle was measured between the distal basilar and the vertical long axis of the aneurysm. The measurements were compared between small ( 3 ) and mass (g) of the deployed coils was also compared. Results Among 94 consecutive aneurysms, 62 (66%) were 3 (±1366) respectively. The median aneurysm follow-up was 24 months (IQR 6–59). There was no difference between the groups based on age, gender, or associated comorbidities. The coil mass was 0.4 g (±0.2) for aneurysms 3 for aneurysms 3 for aneurysms ≥10 mm (P o (±14.4) compared with 1.1 o (±2.8) for aneurysms Conclusion Large coiled basilar apex aneurysms may be more prone to aneurysm tilting and bending of the basilar artery. Speculative causes include the weight of the coil mass and the biomechanical forces exerted on the coiled aneurysm.