Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Temporary Semi-Jailing Technique for Coil Embolization of Wide-Neck Aneurysm with Small Caliber Parent Artery Following Incomplete Clipping

  • Byun, Jun Soo (Department of Radiology, Chung-Ang University College of Medicine) ;
  • Kim, Jae Kyun (Department of Radiology, Chung-Ang University College of Medicine) ;
  • Lee, Hwa Yeon (Department of Radiology, Chung-Ang University College of Medicine) ;
  • Hwang, Sung Nam (Department of Neurosurgery, Chung-Ang University College of Medicine)
  • Received : 2012.05.07
  • Accepted : 2013.04.08
  • Published : 2013.04.28
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Abstract

The authors describe the use of a self-expandable stent in a temporary deployment for treatment of a very wide-neck A1 segment of anterior cerebral artery (ACA) aneurysm following incomplete clipping. A 39-year-old hypertensive man presenting with seizure-like movement underwent computed tomography, which showed acute subarachnoid hemorrhage and an A1 segment of ACA aneurysm with superior and inferior projection. He underwent surgical clipping of the aneurysm, but superior and posterior portion of wide-neck aneurysm remained. We decided to treat the remnant aneurysm using an endovascular modality. After selection of the aneurysm, coil packing was performed assisted by the temporary semi-jailing technique. The Enterprise stent (Cordis Neurovascular, Miami, FL, USA) was deployed and recaptured repeatedly for angiography to ensure safety of the small caliber parent artery. Successful semi-deployment and recapture of the stent allowed subtotal coil occlusion of the aneurysm with good anatomic and clinical results. No complications were encountered. The stent could be recaptured up to the point where the proximal end of the stent marker was aligned with distal marker band of the microcatheter, approximately 70% of the stent length. The temporary semi-jailing technique is feasible for wide-neck aneurysm with small caliber parent artery.

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References

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  2. Semi-Jailing Technique Using a Neuroform3 Stent for Coiling of Wide-Necked Intracranial Aneurysms vol.60, pp.2, 2017, https://doi.org/10.3340/jkns.2016.0607.002