Ahead of Print: Mid-Term Results of Endovascular Coiling of wide-Necked Aneurysms Using Double Stents in “Y-Configuration”
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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.
Full article access for Neurosurgery subscribers at Neurosurgery-Online.com.
