Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
권호 표지
DOI QR코드

DOI QR Code

Modified 'Y-Configured Stents with Waffle Cone Technique' for Broad Neck Basilar Top Aneurysm

  • Cho, Jun-Sung (Department of Neurosurgery, Dankook University College of Medicine) ;
  • Kim, Young-Joon (Department of Neurosurgery, Dankook University College of Medicine)
  • Received : 2010.09.17
  • Accepted : 2011.11.29
  • Published : 2011.12.28
Download PDF
⟨ Previous Next ⟩

Abstract

Stent assisted coiling on intracranial broad neck aneurysm has been considered as an effective technique and has made the complex aneurysms amenable to coiling. However, stent navigation and application themselves often have the problems especially when the parent vessel angle (entrance between afferent and efferent vessel) is over 90 degrees. We report here a case of a ruptured broad neck basilar top aneurysm that was successfully coiled using two self-expandable stents (Enterprise and Neuroform) placed in a fashion of modified Y-configured stents with waffle cone technique.

Keywords

References

  1. Biondi A, Janardhan V, Katz JM, Salvaggio K, Riina HA, Gobin YP : Neuroform stent-assisted coil embolization of wide-neck intracranial Kimaneurysms : strategies in stent deployment and midterm follow-up. Neurosurgery 61 : 460-468; discussion 468-469, 2007 https://doi.org/10.1227/01.NEU.0000290890.62201.A9
  2. Fiorella D, Albuquerque FC, Deshmukh VR, McDougall CG : Usefulness of the Neuroform stent for the treatment of cerebral aneurysms : results at initial (3-6-mo) follow-up. Neurosurgery 56 : 1191-1202; discussion 1201-1202, 2005 https://doi.org/10.1227/01.NEU.0000159645.86823.AF
  3. Horowitz M, Levy E, Sauvageau E, Genevro J, Guterman LR, Hanel R, et al. : Intra/extra-aneurysmal stent placement for management of complex and wide-necked- bifurcation aneurysms : eight cases using the waffle cone technique. Neurosurgery 58 : ONS258-ONS262; discussion ONS262, 2006
  4. Katsaridis V, Papagiannaki C, Violaris C : Embolization of acutely ruptured and unruptured wide-necked cerebral aneurysms using the neuroform2 stent without pretreatment with antiplatelets : a single center experience. AJNR Am J Neuroradiol 27 : 1123-1128, 2006
  5. Kim YJ : Early experiences of neuroform stent-assisted coiling in ruptured intracranial aneurysms. Interv Neuroradiol 13 : 31-44, 2007
  6. Kwon OK, Kim SH, Oh CW, Han MH, Kang HS, Kwon BJ, et al. : Embolization of wide-necked aneurysms with using three or more microcatheters. Acta Neurochir (Wien) 148 : 1139-1145; discussion 1145, 2006 https://doi.org/10.1007/s00701-006-0876-4
  7. Molyneux A, Kerr R, Stratton I, Sandercock P, Clarke M, Shrimpton J, et al. : International Subarachnoid Aneurysm Trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms : a randomised trial. Lancet 360 : 1267-1274, 2002 https://doi.org/10.1016/S0140-6736(02)11314-6
  8. Molyneux AJ, Kerr RS, Yu LM, Clarke M, Sneade M, Yarnold JA, et al. : International subarachnoid aneurysm trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms : a randomised comparison of effects on survival, dependency, seizures, rebleeding, subgroups, and aneurysm occlusion. Lancet 366 : 809-817, 2005 https://doi.org/10.1016/S0140-6736(05)67214-5
  9. Moret J, Cognard C, Weill A, Castaings L, Rey A : [Reconstruction technic in the treatment of wide-neck intracranial aneurysms. Long-term angiographic and clinical results. Apropos of 56 cases.] J Neuroradiol 24 : 30-44, 1997
  10. Perez-Arjona E, Fessler RD : Basilar artery to bilateral posterior cerebral artery 'Y stenting' for endovascular reconstruction of wide-necked basilar apex aneurysms : report of three cases. Neurol Res 26 : 276-281, 2004 https://doi.org/10.1179/016164104225013969
  11. Sedat J, Chau Y, Mondot L, Vargas J, Szapiro J, Lonjon M : Endovascular occlusion of intracranial wide-necked aneurysms with stenting (Neuroform) and coiling : mid-term and long-term results. Neuroradiology 51 : 401-409, 2009 https://doi.org/10.1007/s00234-009-0502-2
  12. Thorell WE, Chow MM, Woo HH, Masaryk TJ, Rasmussen PA : Y-configured dual intracranial stent-assisted coil embolization for the treatment of wide-necked basilar tip aneurysms. Neurosurgery 56 : 1035-1040; discussion 1035-1040, 2005
  13. Vallee JN, Pierot L, Bonafé A, Turjman F, Flandroy P, Berge J, et al. : Endovascular treatment of intracranial wide-necked aneurysms using three-dimensional coils : predictors of immediate anatomic and clinical results. AJNR Am J Neuroradiol 25 : 298-306, 2004

Cited by

  1. Stent/Balloon Combination Assist Technique for Wide-Necked Basilar Terminal Aneurysms vol.19, pp.3, 2011, https://doi.org/10.1177/159101991301900306
  2. Y-configured Stent-assisted Coil Embolization of Basilar Bifurcation Aneurysms: report of 2 cases vol.7, pp.4, 2011, https://doi.org/10.5797/jnet.7.266
  3. Waffle‐Cone Technique Using Solitaire AB Stent for Endovascular Treatment of Complex and Wide‐Necked Bifurcation Cerebral Aneurysms vol.24, pp.6, 2014, https://doi.org/10.1111/jon.12121
  4. Waffle Y technique: pCONus for tandem bifurcation aneurysms of the middle cerebral artery vol.6, pp.10, 2011, https://doi.org/10.1136/neurintsurg-2013-010921.rep
  5. Hybrid Y Stenting with the Waffle-Cone : A Technical Note vol.20, pp.6, 2011, https://doi.org/10.15274/inr-2014-10065
  6. Coiling of a recurrent broad-necked posterior communicating aneurysm incorporating a fetal cerebral artery: A technical case report vol.21, pp.1, 2011, https://doi.org/10.15274/inr-2014-10088
  7. The effectiveness of the waffle-cone technique in treating complex intracranial aneurysms vol.21, pp.4, 2011, https://doi.org/10.1177/1591019915590529
  8. Intra-aneurysmal hemodynamics: evaluation of pCONus and pCANvas bifurcation aneurysm devices using DSA optical flow imaging vol.8, pp.11, 2016, https://doi.org/10.1136/neurintsurg-2015-011927
  9. Endosurgical Remodeling of Wide-Necked Bifurcation Aneurysms vol.10, pp.None, 2011, https://doi.org/10.3389/fneur.2019.00245