Document Detail


Stent reconstruction of wide-necked aneurysms across the circle of Willis.
MedLine Citation:
PMID:  18091239     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To describe a novel technique for single stent reconstruction of wide-necked aneurysms arising from the circle of Willis. METHODS: Neuroform stents (Boston Scientific/Target, Fremont, CA) were placed across the basilar apex (right P1 to left P1) via the posterior communicating artery in two patients, across the left carotid terminus (left A1 to left M1) via the anterior communicating artery in two patients, and across the anterior communicating artery (left A1 to right A1) in one patient for stent-supported coil embolization. RESULTS: Five women underwent successful deployment of the Neuroform stent across the circle of Willis to support subsequent coil embolization of a wide-necked cerebral aneurysm. In two patients with subarachnoid hemorrhage, initial dome coiling was performed for short-term protection, and stents were applied across the circle of Willis to support completion of coil embolization during a second session. None of the patients experienced any periprocedural or delayed neurological complications. CONCLUSION: Stenting across the circle of Willis represents a novel adjuvant technique to support the coiling of selected wide-necked intracranial aneurysms. This technique is particularly useful for wide-necked terminal aneurysms that incorporate both branches of a bifurcation in a configuration unfavorable for Y-stent reconstruction.
Authors:
Michael E Kelly; Raymond Turner; Vivek Gonugunta; Henry H Woo; Peter A Rasmussen; Thomas J Masaryk; David Fiorella
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Neurosurgery     Volume:  61     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-12-19     Completed Date:  2008-02-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  249-54; discussion 254-5     Citation Subset:  IM    
Affiliation:
Division of Cerebrovascular and Endovascular Neurosurgery, Department of Neurosurgery, The Cleveland Clinic, Cleveland, Ohio 44195, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Blood Vessel Prosthesis Implantation / methods*
Cerebral Angiography / methods
Circle of Willis / pathology,  surgery*
Female
Humans
Intracranial Aneurysm / pathology,  surgery*
Middle Aged
Posterior Cerebral Artery / pathology,  surgery
Stents*

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


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