"Y" and "X" stent-assisted coiling of complex and wide-neck intracranial bifurcation aneurysms.

Details

Serval ID
serval:BIB_818563C06AC2
Type
Article: article from journal or magazin.
Collection
Publications
Title
"Y" and "X" stent-assisted coiling of complex and wide-neck intracranial bifurcation aneurysms.
Journal
AJNR. American journal of neuroradiology
Author(s)
Bartolini B., Blanc R., Pistocchi S., Redjem H., Piotin M.
ISSN
1936-959X (Electronic)
ISSN-L
0195-6108
Publication state
Published
Issued date
2014
Peer-reviewed
Oui
Volume
35
Number
11
Pages
2153-2158
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Stent-assisted coiling with two stents has been described in some series for the treatment of complex and wide-neck bifurcation aneurysms. Our aim was to report our experience of a stent-assisted coiling technique with double stents in "Y" and "X" configurations, with emphasis on safety, feasibility, and efficacy.
Clinical and angiographic outcomes of patients for whom the strategic therapeutic option was the stent-assisted coiling technique in a Y or X configuration for neck scaffolding from June 2006 to June 2013 were retrospectively analyzed.
One hundred five aneurysms in 97 patients were treated during 100 consecutive procedures. There were 54.2% (57/105) MCA, 28.6% (30/105) anterior communicating artery, 16.2% (17/105) basilar tip, and 1.0% (1/105) ICA termination aneurysms. A Y stent placement was used to treat 87 aneurysms in 85 procedures; an X stent placement was used to treat 7 aneurysms in 6 procedures, while 9 procedures failed for 11 aneurysms. There were 10.0% (10/100) procedure-related permanent neurologic deficits and 1.0% (1/100) death. The immediate angiographic controls showed a complete occlusion in 47.6% (50/105) of the aneurysms and a partial (neck or sac remnant) occlusion in 52.4% (55/105). To date, 81.0% (85/105) of the aneurysms have been followed up (mean, 17 months) with angiography, disclosing a recanalization in 5.9% (5/85) and an improvement in 42.4% (36/85). At discharge and follow-up, the mRS score was 0 in 83.5% (81/97) of patients, 1 in 4.1% (4/97), 2 in 3.1% (3/97), 3 in 4.1% (4/97), 4 in 3.1% (3/97), and 6 in 2.1% (2/97).
Y and X stent-assisted coiling of complex and wide-neck intracranial bifurcation aneurysms is an effective technique.

Keywords
Aged, Blood Vessel Prosthesis, Cerebral Angiography, Embolization, Therapeutic/adverse effects, Embolization, Therapeutic/instrumentation, Embolization, Therapeutic/methods, Endovascular Procedures/adverse effects, Endovascular Procedures/instrumentation, Endovascular Procedures/methods, Female, Humans, Intracranial Aneurysm/diagnostic imaging, Intracranial Aneurysm/therapy, Male, Middle Aged, Postoperative Complications/epidemiology, Retrospective Studies, Stents, Treatment Outcome, Young Adult
Pubmed
Open Access
Yes
Create date
03/05/2017 12:44
Last modification date
20/08/2019 15:41
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