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Mid-Term Results of Endovascular Coiling of wide-Necked Aneurysms Using Double Stents in "Y-Configuration"
MedLine Citation:
PMID:  21389887     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND:: Double stenting in Y-configuration may be used to treat a subset of wide-necked aneurysms not amenable to reconstruction with a single stent. Objective: We studied the feasibility, safety and mid-term angiographic outcome of patients treated using this technique. METHODS:: A retrospective review was undertaken of all coil embolizations of wide-necked aneurysms employing double stents in Y-configuration. RESULTS:: Nineteen patients were identified from 2002 to 2010 (14 female, 5 male) with a mean age of 57.4 years. Stents were deployed in a Y-configuration achieving complete occlusion (5/19), residual neck (5/19) and residual aneurysm filling (9/19). Angiographic follow up was available for a mean of 16 months and clinical follow up is available for a mean of 21.4 months. The incidence of complications at the initial treatment was 6/19 (31.6%) and delayed thromboembolic complications occurred in 2/19 (10.5%). Only one of the patients in which a complete occlusion was obtained on the initial treatment developed an angiographic neck recurrence requiring re-treatment. Spontaneous thrombosis and complete occlusion on follow up imaging was found in six patients in whom initial neck or aneurysm filling was observed. Ultimately, twelve (63.2%) of the aneurysms were completely occluded on follow up angiography. CONCLUSION:: Y-stent reconstruction enables the endovascular management of otherwise complex, wide-necked cerebral aneurysms and can be performed safely in experienced hands with satisfactory mid-term results even in cases requiring re-treatment.
Authors:
Alejandro M Spiotta; Rishi Gupta; David Fiorella; Vivekananda Gonugunta; Bjorn Lobo; Peter A Rasmussen; Shaye I Moskowitz
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-08
Journal Detail:
Title:  Neurosurgery     Volume:  -     ISSN:  1524-4040     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-3-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1Department of Neurosurgery, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA; 2Vanderbilt Stroke Center, The Vanderbilt Clinic, Nashville, Tennessee, USA; 3Stony Brook University, Stony Brook, New York, USA; 4Cerebrovascular Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.
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