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Stepwise stent deployment technique for tandem intracranial aneurysms: a review of 21 cases

  • Vascular-Interventional
  • Published:
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Abstract

Objectives

We performed this study to report our experience using a stepwise stent deployment technique for the treatment of tandem intracranial aneurysms.

Methods

Patients with intracranial tandem aneurysms that were treated with a stepwise stent deployment technique between May 2009 and June 2013 were retrospectively reviewed.

Results

Twenty-one patients with 42 tandem aneurysms were identified (11 men, 10 women), with a mean age of 53.7 years (range, 17–82 years). Subarachnoid haemorrhage was confirmed in 12 patients using computed tomography at onset. Complete occlusion was achieved in 20 of the aneurysms (47.6 %) after the procedure, neck remnant in 9 (21.4 %), and aneurysm remnant in 13 (31.0 %). The perioperative complications included in-stent thrombosis in one case and vasospasm in two cases, none of which left a permanent neurological deficit. The modified Rankin Scale (mRS) score at discharge was 0–2 in 20 cases and 3 in one case. The follow-up angiograms available for 17 patients showed complete occlusion in 26 aneurysms, improved in 4, and stable in 4. All of the patients had mRS scores of 0–1 during the clinical follow-up period.

Conclusions

The stepwise stent deployment technique is feasible and helpful in the treatment of intracranial tandem aneurysms.

Key Points

• Treating wide-necked intracranial aneurysms with stent-assisted coiling is preferable.

• Tandem wide-necked intracranial aneurysms can be treated with a single stent.

• Stepwise stent deployment is technically feasible for embolizing tandem intracranial aneurysms.

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Abbreviations

mRS:

Modified Rankin Scale

ACA:

Anterior cerebral artery

AChA:

Anterior choroidal artery

MCA:

Middle cerebral artery

PCoA:

Posterior communicating artery

ICA:

Internal carotid artery

SAH:

Subarachnoid haemorrhage

SAC:

Stent-assisted coiling

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Acknowledgements

The scientific guarantor of this publication is Jian-Min Liu. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. This study has received funding by the Foundation of Shanghai Public Health Bureau (No. 20114232), Shanghai Science and Technology Development Funds (No 13140903201), the Major Programs of the Changhai Hospital during the 12th Five-Year Plan Period (No. CH125520103), and the National Natural Science Foundation of China (No. 81301004, 81271271). Yi-Bin Fang kindly provided statistical advice for this manuscript. No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. No study subjects or cohorts have been previously reported. Methodology: retrospective, observational, performed at one institution. Yi-Bin Fang and Zhao-Long Zhang contributed equally to this work.

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    Authors and Affiliations

    1. Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China, 200433

      Yi-Bin Fang, Zhao-Long Zhang, Peng-Fei Yang, Wan-Ling Wen, Bo Hong, Yi Xu, Wen-Yuan Zhao, Qing-Hai Huang & Jian-Min Liu

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    1. Yi-Bin Fang
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    2. Zhao-Long Zhang
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    3. Peng-Fei Yang
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    Correspondence to Qing-Hai Huang or Jian-Min Liu.

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    Yi-Bin Fang and Zhao-Long Zhang contributed equally to this work and are both first co-authors.

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    Fang, YB., Zhang, ZL., Yang, PF. et al. Stepwise stent deployment technique for tandem intracranial aneurysms: a review of 21 cases. Eur Radiol 26, 351–358 (2016). https://doi.org/10.1007/s00330-015-3823-z

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    • DOI: https://doi.org/10.1007/s00330-015-3823-z

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