Abstract
Endovascular coil occlusion of fusiform intracranial aneurysms without sacrifice of the parent artery can be technically challenging. Bridging of wide aneurysm necks with stents is common practice for side-wall aneurysms but is less frequently used for bifurcation aneurysms. We describe the technical aspects of the successful coil occlusion of a fusiform aneurysm of the upper basilar trunk, with preservation of the parent vessel. The procedure comprised the following steps: (a) stenting of the left V1- and proximal V2 segments; (b) simultaneous deployment of two Neuroform stents from both P1 segments down to the basilar artery (“kissing” stents) (c) using a TriSpan device to hold (d) three-dimensional electrolytically detachable coils in place and (e) filling the aneurysmal lumen mainly with fibered electrolytically detachable coils; and finally (f) cutting the extracorporeal part of both microguidewires below the skin level in both groins, leaving the microguidewires as they were used for the deployment of the stents in place, thus reaching from both P2 segments down to the basilar artery and further proximally.
Similar content being viewed by others
References
Molyneux A, Kerr R, Stratton I, Sandercock P, Clarke M, Shrimpton J, Holman R, International Subarachnoid Trial (ISAT) Collaborative Group (2002) International Subarachnoid Trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised trial. Lancet 360:1267–1274
Henkes H, Fischer S, Weber W, Miloslavski E, Felber S, Brew S, Kuehne D (2004) Endovascular coil occlusion of 1811 intracranial aneurysms: early angiographic and clinical results. Neurosurgery 54:268–285
Cloft HJ, Joseph GJ, Tong FC, Goldstein JH, Dion JE (2000) Use of three-dimensional Guglielmi detachable coils in the treatment of wide-necked cerebral aneurysms. Am J Neuroradiol 21:1312–1314
Moret J, Cognard C, Weill A, Castaigns L, Rey A (1997) The “remodelling technique” in the treatment of wide neck intracranial aneurysms. Interv Neuroradiol 3:21–35
Henkes H, Bose A, Felber S, Miloslavski E, Berg-Dammer E, Kühne D (2002) Endovascular coil occlusion of intracranial aneurysms assisted by a novel self-expandable nitinol microstent (Neuroform). Interv Neuroradiol 107–119
Raymond J, Guilbert F, Roy D (2001) Neck-bridge device for endovascular treatment of wide-neck bifurcation aneurysms: initial experience. Radiology 221:318–326
Seifert V, Raabe A, Stolke D (2001) Management-related morbidity and mortality in unselected aneurysms of the basilar trunk and vertebrobasilar junction. Acta Neurochir (Wien) 143:343–348
Byrne JV, Sohn MJ, Molyneux AJ, Chir B (1999) Five-year experience in using coil embolization for ruptured intracranial aneurysms: outcomes and incidence of late rebleeding. J Neurosurg 90:656–663
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Henkes, H., Kirsch, M., Mariushi, W. et al. Coil treatment of a fusiform upper basilar trunk aneurysm with a combination of “kissing” neuroform stents, TriSpan-, 3D- and fibered coils, and permanent implantation of the microguidewires. Neuroradiology 46, 464–468 (2004). https://doi.org/10.1007/s00234-004-1192-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00234-004-1192-4