Document Detail


Semi-jailing technique for coil embolization of complex, wide-necked intracranial aneurysms.
MedLine Citation:
PMID:  19934972     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Stent-assisted coiling of intracranial aneurysms is performed by placing a microcatheter through a stent's interstices or jailing the microcatheter between the stent and the artery. Both approaches impede manipulation of the microcatheter during coiling. We describe a modified jailing technique that improves catheter maneuverability and report the safety and efficacy of the method for the treatment of complex, wide-necked aneurysms. METHODS: The semi-jailing technique involves the partial deployment of a retrievable stent, bridging part of the aneurysm neck while leaving space to maneuver the microcatheter. Twenty-two complex, wide-necked aneurysms, including 3 ruptured and 5 dissecting, were treated using the semi-jailing technique (15 women; mean age, 55.2 years). RESULTS: The semi-jailing technique was successfully applied in all cases. Immediate posttreatment angiograms showed total occlusion of the aneurysm in 17 cases (77%), neck remnant in 3 cases (14%), and aneurysm dome filling in 2 cases (9%). Follow-up angiography available in 10 patients at an average of 8.5 months showed progressive occlusion in 1 aneurysm and 7 remained occluded. In 2 cases of dissecting aneurysms, retreatment was required. No permanent periprocedural morbidity was encountered. One patient died of complications secondary to intracranial hemorrhage 6 days after treatment. In 2 cases (9%), thromboembolic events after final stent placement were successfully treated with intraarterial thrombolysis. No delayed stent migration was seen. CONCLUSION: Semi-jailing is a safe and effective stent-assisted coiling technique that facilitates treatment of complex, wide-necked aneurysms.
Authors:
Bo Hong; Neil V Patel; Matthew J Gounis; Michael J DeLeo; Italo Linfante; Joan C Wojak; Ajay K Wakhloo
Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Neurosurgery     Volume:  65     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-11-25     Completed Date:  2010-02-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1131-8; discussion 1138-9     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Changhai Hospital, 2nd Military Medical University, Shanghai, People's Republic of China.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aspirin / therapeutic use
Blood Vessel Prosthesis*
Cerebral Angiography / methods
Embolization, Therapeutic / instrumentation*,  methods*
Female
Humans
Intracranial Aneurysm / pathology,  therapy*
Male
Microsurgery
Middle Aged
Platelet Aggregation Inhibitors / therapeutic use
Prosthesis Design
Stents*
Ticlopidine / analogs & derivatives,  therapeutic use
Treatment Outcome
Chemical
Reg. No./Substance:
0/Platelet Aggregation Inhibitors; 50-78-2/Aspirin; 55142-85-3/Ticlopidine; 90055-48-4/clopidogrel

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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