Background and importance: The endovascular treatment of recurrent wide-necked bifurcation aneurysms at the basilar tip remains very challenging. Many different techniques and devices have emerged in recent years as potential options but results remain less than controversial. The pCANvas is a relatively new device wielding neck-bridging properties with a haemodynamically active membrane acting as blood flow disrupter.
Clinical presentation: We present the clinical case of a patient in whom multiple endovascular and microsurgical attempts failed to achieve the definitive treatment of a large and wide-necked basilar tip aneurysm. The patient underwent successful endovascular implantation of the novel pCANvas device across the recurrent aneurysm neck. The device limited the blood flow to the anerysmal lumen and thus promoted faster thrombosis. Third month follow-up confirmed complete obliteration of the aneurysm.
Conclusion: The application of the pCANvas device offers a potential treatment option in difficult and recurrent aneurysms. The endovascular flow disruption is a relatively new feature aiming to create conditions for intraluminal thrombosis and is certainly promising for the treatment of complex bifurcation aneurysms.
Keywords: Aneurysm; basilar tip; pCANvas; wide-necked.