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Research ArticleInterventional

Temporary Solitaire Stent–Assisted Coiling: A Technique for the Treatment of Acutely Ruptured Wide-Neck Intracranial Aneurysms

F. Signorelli, B. Gory and F. Turjman
American Journal of Neuroradiology May 2014, 35 (5) 984-988; DOI: https://doi.org/10.3174/ajnr.A3798
F. Signorelli
aFrom the Departments of Neurosurgery (F.S.)cDepartment of Experimental and Clinical Medicine (F.S.), University Magna Græcia, Catanzaro, Italy.
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B. Gory
bInterventional Neuroradiology (B.G., F.T.), Hôpital Neurologique Pierre Wertheimer, Lyon, France
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F. Turjman
bInterventional Neuroradiology (B.G., F.T.), Hôpital Neurologique Pierre Wertheimer, Lyon, France
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    Fig 1.

    A 55-year-old man (patient 1) with a ruptured anterior communicating artery (AcomA) aneurysm. A, Initial angiogram shows a wide-neck AcomA aneurysm associated with the median artery of the corpus callosum. B, Balloon is positioned across the aneurysm neck and the first coil is inserted into the aneurysm with the balloon inflated. The first coil prolapses into the right A2 when the balloon is deflated (arrow). C, The deployed but undetached stent is positioned in the left A1 and right A2 segments from the left (arrowhead); the balloon is placed in the left A2 (arrow) and the microcatheter into the aneurysmal sac. D, Postprocedural angiogram demonstrates complete aneurysm occlusion after stent retrieval.

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    Fig 2.

    A 52-year-old woman (patient 7) with a complex MCA aneurysm. A and B, Initial angiogram shows a broad-based, bilobed MCA bifurcation aneurysm. An additional paraophthalmic aneurysm is noted. C, The undeployed stent is positioned across the superior trunk (arrow) and the balloon placed to protect the inferior trunk from coil migration. A vasospasm in the superior division of MCA was observed. D, The stent is deployed (arrow), and aneurysm packing is performed. The distal stent markers appear to be outside the vessel wall, an appearance that is related to vasospasm. E and F, A thromboembolic adverse event occurred during inflation of the balloon in the inferior MCA branch, which resulted in no clinical disability.

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    Table 1:

    Clinical and angiographic features

    PatientSex/Age, yFisher ScoreWFNS GradeAneurysm LocationSac Size, mmNeck Size, mmComplementary Technique
    1Male/55IIIAcomA4 × 2.54RB
    2Male/51IIIVMedium-basilar21 × 138
    3Female/58IVVRight carotido-ophthalmic12 × 106
    4Female/77IIIVertebrobasilar junction9 × 1010
    5Female/43IVILeft PcomA4 × 3.53.5
    6Female/81IVILeft PcomA3 × 2.53
    7Female/52IIIVaRight MCA10 × 55RB
    8Male/43IVVLeft PcomA22 × 167
    • Note:—AcomA indicates anterior communicating artery; RB, remodeling balloon; PcomA, posterior communicating artery.

    • ↵a WFNS grade improved to III after EVD placement.

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    Table 2:

    Clinical and angiographic outcomes

    PatientmRS Score at DischargeAneurysmal Occlusion/Initial 1-Year Follow-UpFurther Treatment
    10Complete/CompleteNone
    24Complete/CompleteNone
    35Neck remnant/Neck remnantNone
    40Neck remnant/RecanalizationSAC (complete occlusion)
    50Complete/CompleteNone
    63Neck remnant/RecanalizationSAC (complete occlusion)
    71Complete/CompleteNone
    86Complete/CompleteNone
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American Journal of Neuroradiology: 35 (5)
American Journal of Neuroradiology
Vol. 35, Issue 5
1 May 2014
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Temporary Solitaire Stent–Assisted Coiling: A Technique for the Treatment of Acutely Ruptured Wide-Neck Intracranial Aneurysms
F. Signorelli, B. Gory, F. Turjman
American Journal of Neuroradiology May 2014, 35 (5) 984-988; DOI: 10.3174/ajnr.A3798

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Temporary Solitaire Stent–Assisted Coiling: A Technique for the Treatment of Acutely Ruptured Wide-Neck Intracranial Aneurysms
F. Signorelli, B. Gory, F. Turjman
American Journal of Neuroradiology May 2014, 35 (5) 984-988; DOI: 10.3174/ajnr.A3798
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