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Research ArticleInterventional

“Y” and “X” Stent-Assisted Coiling of Complex and Wide-Neck Intracranial Bifurcation Aneurysms

B. Bartolini, R. Blanc, S. Pistocchi, H. Redjem and M. Piotin
American Journal of Neuroradiology November 2014, 35 (11) 2153-2158; DOI: https://doi.org/10.3174/ajnr.A4060
B. Bartolini
aFrom the Department of Interventional and Functional Neuroradiology, Foundation Rothschild Hospital, Paris, France.
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R. Blanc
aFrom the Department of Interventional and Functional Neuroradiology, Foundation Rothschild Hospital, Paris, France.
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S. Pistocchi
aFrom the Department of Interventional and Functional Neuroradiology, Foundation Rothschild Hospital, Paris, France.
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H. Redjem
aFrom the Department of Interventional and Functional Neuroradiology, Foundation Rothschild Hospital, Paris, France.
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M. Piotin
aFrom the Department of Interventional and Functional Neuroradiology, Foundation Rothschild Hospital, Paris, France.
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Abstract

BACKGROUND AND PURPOSE: 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.

MATERIALS AND METHODS: 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.

RESULTS: 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).

CONCLUSIONS: Y and X stent-assisted coiling of complex and wide-neck intracranial bifurcation aneurysms is an effective technique.

ABBREVIATION:

AcomA
anterior communicating artery
  • © 2014 by American Journal of Neuroradiology
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American Journal of Neuroradiology: 35 (11)
American Journal of Neuroradiology
Vol. 35, Issue 11
1 Nov 2014
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“Y” and “X” Stent-Assisted Coiling of Complex and Wide-Neck Intracranial Bifurcation Aneurysms
B. Bartolini, R. Blanc, S. Pistocchi, H. Redjem, M. Piotin
American Journal of Neuroradiology Nov 2014, 35 (11) 2153-2158; DOI: 10.3174/ajnr.A4060

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“Y” and “X” Stent-Assisted Coiling of Complex and Wide-Neck Intracranial Bifurcation Aneurysms
B. Bartolini, R. Blanc, S. Pistocchi, H. Redjem, M. Piotin
American Journal of Neuroradiology Nov 2014, 35 (11) 2153-2158; DOI: 10.3174/ajnr.A4060
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