Document Detail


In Vitro Studies for Stent Assisted Coiling of Terminus Aneurysms by Straight on Intra-Aneurysmal Stent Deployment.
MedLine Citation:
PMID:  23298669     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: Deployment of a Neuroform microstent (NFM) within acutely angled geometry may result in substantial deformations. This in vitro study was conducted to validate a novel alternative technique, consisting of intentional deployment of a NFM straight on into a terminus aneurysm, by assessing the mechanics, feasibility, and stability of the coils. METHODS: Silicon models of wide-neck terminus aneurysms were constructed. Straight on deployment of a NFM from the afferent vessel into the aneurysm was compared with conventional cross-neck deployment at a right angle position followed by Guglielmi Detachable Coil embolization simulation. The supporting forces of the two different methods of deployment were compared by using side-wall eccentric and en face compression tests. RESULTS: Straight on deployment of a NFM at a wide-neck terminus aneurysm was a relatively simple technique compared to cross-neck right angle deployment. Good stability of the coil mass was consistently achieved with adequate preservation of the parent vessel lumen. A larger residual neck space at the side without the stent and much coil mass protruded into parent vessel were observed in cross-neck stent deployment. Compression tests revealed a larger supporting force of the NFM with straight on deployment compared to the side wall radial force (p < 0.05). A potential problem with this technique is the possible inability or difficulty in retrieving a partially deployed coil. CONCLUSION: Stent-assisted coiling of wide-neck terminus aneurysms with straight on deployment of NFM consistently achieved a stable NFM-coil complex. The NFM also had a better supporting force in a straight position. Some technical difficulties may be encountered during subsequent coiling. This alternative technique to conventional cross-neck bridging appears to be another strategy for wide-neck terminus aneurysm coiling.
Authors:
Shih-Wei Hsu; John C Chaloupka; Mitsuyuki Fujitsuka
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-5
Journal Detail:
Title:  World neurosurgery     Volume:  -     ISSN:  1878-8750     ISO Abbreviation:  World Neurosurg     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101528275     Medline TA:  World Neurosurg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 Elsevier Inc. All rights reserved.
Affiliation:
Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taiwan, R.O.C. Electronic address: hsusw@adm.cgmh.org.tw.
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