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Acta Neurochirurgica

, Volume 156, Issue 9, pp 1677–1686 | Cite as

Y-configuration double-stent-assisted coiling using two closed-cell stents for wide-neck basilar tip aneurysms

  • Pyoung Jeon
  • Byung Moon KimEmail author
  • Dong Joon Kim
  • Dong I. k Kim
  • Keun Young Park
Clinical Article - Vascular

Abstracts

Background

This study aimed to evaluate clinical and angiographic outcomes of Y-configuration double-stent-assisted (Y-stent) coiling using two closed-cell stents for wide-necked basilar tip aneurysm (BTA).

Materials

A total of 25 patients underwent Y-stent coiling using two closed-cell stents as a first-time treatment in 18 (3 ruptured) BTAs, retreatment in 2 BTAs and as a third treatment in 5 wide-necked BTAs. Clinical and angiographic outcomes were evaluated retrospectively.

Results

Treatment-related complications were three (12.0 %) thromboembolic infarctions due to two acute in-stent thromboses and one embolism. Twenty-two (88 %) patients had favorable outcomes (modified Rankin scale score [mRS], 0–2) during the follow-up period (mean, 30 months; range, 6–54 months). Two patients died: one from initial subarachnoid hemorrhage and the other from intracerebral hemorrhage due to underlying Moyamoya disease. Post-treatment angiograms showed complete occlusion in nine aneurysms, residual neck in 11 aneurysms and residual sac in five aneurysms. Follow-up angiograms were available at least once between 5 to 34 months (mean, 16 months) in 21 patients. Nineteen patients showed improved or stable states (complete occlusion, n = 17; residual neck, n = 2). Major recurrences occurred in two BTAs (9.5 %). Those two major recurrent aneurysms had been large-sized aneurysms at the initial coiling procedure. Both showed not only coil compaction but also progressive growth to giant-sized aneurysms and intra-aneurysmal thrombus formation at the Y-stent coiling as a third-time treatment.

Conclusions

Y-stent coiling using two closed-cell stents is a safe and durable treatment option for wide-necked BTA, but may have limited efficacy for large/giant sized and thrombosed aneurysms.

Keywords

Aneurysm Basilar artery Coiling Stent-assistance 

Notes

Conflict of interest

None.

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Copyright information

© Springer-Verlag Wien 2014

Authors and Affiliations

  • Pyoung Jeon
    • 1
  • Byung Moon Kim
    • 2
    Email author
  • Dong Joon Kim
    • 2
  • Dong I. k Kim
    • 2
  • Keun Young Park
    • 3
  1. 1.Department of Radiology, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulSouth Korea
  2. 2.Department of Radiology, Division of Interventional NeuroradiologySeverance Hospital, Yonsei University College of MedicineSeoulSouth Korea
  3. 3.Department of Neurosurgrey, Severance HospitalYonsei University College of MedicineSeoulSouth Korea

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