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Introduction Subarachnoid hemorrhage (SAH) due to ruptured intracranial aneurysms in the posterior circulation, presents a significant clinical challenge with high morbidity and mortality. Dissecting aneurysms of the basilar artery (BA) are rare and often require complex therapeutic decisions. We report a case of a dissecting basilar artery aneurysm with an unusual loop configuration treated successfully using endovascular techniques.Abstract C38 Figure 1Case Description 58-year-old female intubated with crtical neurological status (GCS 7) was admitted to the ED. neCT scan revealed SAH in the basilar cisterns – Fisher grade 4. Angio-CT demonstrated a dissecting aneurysm at the BA bifurcation with a atypical loop configration (Fig.1A-D). Arteriography revealed a ruptured dissecting aneurysm involving the terminal portion of the BA and proximal segments of the PCA’s. Endovascular treatment with a flow diverter stent Pipeline flex 3.25x12 mm, LVIS EVO 3,5x17mm and embolization coils was successfully performed (Fig. 2A-B). The patient‘s postoperative course was satisfactory – regained consciousness with no focal neurological deficits. Follow-up arteriography after 14 days demonstrated minor early recanalisation in the basal part of the aneurysmal loop, prompting a second endovascular procedure during which an additional flow diverter Pipeline Vantage 3,5x12mm was implanted (Fig. 3A-B). The patient was discharged in good neurological condition.Abstract C38 Figure 2Conclusions Basilar artery disssecting aneurysms with atypical configuration are associated with a high risk of recanalization and secondary bleeding, thus their treatment require the most effective endovascular techniques and devices. Endovascular embolisation using flow diverter-assisted coiling is a good option for effective treatment unusual loop shape dissecting basilar artery aneurysm to obtain satisfactory clinical results.Abstract C38 Figure 3Conflict of Interest No