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Evaluation of short- and long-term results of Y-stent-assisted coiling with Leo stents in endovascular treatment of wide-necked intracranial bifurcation aneurysms

  • Interventional Neuroradiology
  • Published:
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Abstract

Purpose

This study aimed to evaluate the feasibility, safety, and efficacy of Y-stent-assisted coiling (Y-SAC) using LEO Baby® stents in treating of bifurcation aneurysms.

Methods

Patients who underwent Y-SAC using a braided stent (LEO Baby®, Montmorency, France) for wide-necked intracranial aneurysms between 2009 and 2019 and whose radiological and clinical follow-up data for at least 6 months could be obtained were evaluated. Data were obtained from patient records and analyzed retrospectively.

Results

We evaluated 111 patients with a mean age of 56.0 ± 10.8 years (range, 25–88 years). Most of the aneurysms were detected incidentally. Three patients had ruptured aneurysms. LEO Baby deployment and coiling were successful in all patients. Immediate aneurysm occlusion rates were determined as modified Raymond-Roy classification (mRRC) I 95.5% (n = 106), mRRC II 3.6% (n = 4), mRRC IIIa 0.9% (n = 1). In the sixth month, aneurysm occlusion rates were found to be complete and nearly complete in all patients (mRRC I 94.6%, n = 105 and mRRC II 4.5%; n = 5, respectively). Follow-up data of 91 patients for > 2 years were obtained. Of these, 88 had MRRCI obstruction and 3 had MRRC II obstruction. The overall complication rate was 4.8%, and one patient died during the post-procedural follow-up.

Conclusion

The long-term follow-up results of Y-stenting with LEO Baby revealed that it provides stable closure of the aneurysm sac while preserving the main arterial structures. Therefore, it is a safe, durable, and effective method for treating wide-necked and complex bifurcation aneurysms.

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Data availability

All data collected during the study can be obtained from the corresponding author.

Abbreviations

AcomA :

Anterior communicating artery

BA :

Basilar artery

CI :

Confidence interval

EVT :

Endovascular treatment

DSA :

Digital subtraction angiography

MRI :

Magnetic resonance imaging

MCA :

Middle cerebral artery

mRS :

Modified Rankin scale

mRRC :

Modified Raymond-Roy classification

RR :

Raymond–Roy

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Authors and Affiliations

  1. Department of Radiology, Basaksehir Cam and Sakura City Hospital, Basaksehir, Istanbul, Turkey

    Kanullah Suleyman

  2. Division of Neuroradiology, Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey

    Bora Korkmazer, Naci Kocer, Civan Islak & Osman Kızılkılıc

  3. Department of Radiology, Division of Neuroradiology, Cerrahpasa Medical School, Kocamustafapasa, Istanbul, 34300, Turkey

    Osman Kızılkılıc

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  1. Kanullah Suleyman
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  2. Bora Korkmazer
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Correspondence to Osman Kızılkılıc.

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Conflict of interest

CI has a consulting and proctoring agreement with Medtronic, Inc., outside of this work. NK has a consulting and proctoring agreement with MicroVention, Inc. and Medtronic, Inc., outside of this work. The other authors have no conflict to declare.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Istanbul University Cerrahpaşa Faculty of Medicine (2019/100035).

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Suleyman, K., Korkmazer, B., Kocer, N. et al. Evaluation of short- and long-term results of Y-stent-assisted coiling with Leo stents in endovascular treatment of wide-necked intracranial bifurcation aneurysms. Neuroradiology 65, 785–791 (2023). https://doi.org/10.1007/s00234-023-03116-x

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  • DOI: https://doi.org/10.1007/s00234-023-03116-x

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