Journal of Korean Neurosurgical Society

  • 제65권1호
  • /
  • Pages.40-48
  • /
  • 2022
  • /
  • 2005-3711(pISSN)
  • /
  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
권호 표지
DOI QR코드

DOI QR Code

Long-Term Outcomes of Placement of a Single Transverse Stent through the Anterior Communicating Artery via the Nondominant A1 in Coil Embolization of Wide-Necked Anterior Communicating Artery Aneurysms

  • Ban, Seung Pil (Department of Neurosurgery, Seoul National University Bundang Hospital) ;
  • Kwon, O-Ki (Department of Neurosurgery, Seoul National University Bundang Hospital) ;
  • Kim, Young Deok (Department of Neurosurgery, Seoul National University Bundang Hospital)
  • 투고 : 2021.07.23
  • 심사 : 2021.10.15
  • 발행 : 2022.01.01
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Objective : Placement of a single transverse stent via the nondominant A1 across the anterior communicating artery (AComA) into the contralateral A2 can provide sufficient neck coverage for wide-necked bifurcation AComA aneurysms. The authors described the feasibility, safety and long-term outcomes of this technique. Methods : Between January 2015 and February 2018, placement of a single transverse stent via the nondominant A1 was attempted in 17 wide-necked bifurcation AComA aneurysms. The authors reviewed the medical records and radiological studies. Results : The technical success rate was 94.1% (16/17). Periprocedural thromboembolic complications occurred in one patient (6.3%) without permanent neurological deficits. The mean clinical follow-up duration was 39.9±9.8 months. No deaths or delayed thromboembolic complications occurred. The mean angiographic follow-up duration was 38.9±9.8 months. The immediate and final follow-up complete occlusion rates were 87.4 and 93.7%, respectively. There was no recanalization during the follow-up period. Conclusion : Placement of a single transverse stent via the nondominant A1 across the AComA into the contralateral A2 is a feasible and relatively safe endovascular technique for the treatment of wide-necked bifurcation AComA aneurysms, with good long-term occlusion rates and a reasonable complication rate, if only the nondominant A1 is applicable.

키워드

과제정보

This study is supported by a fund from Seoul National University Bundang Hospital (06-2013-087).

참고문헌

  1. Adeeb N, Griessenauer CJ, Patel AS, Foreman PM, Baccin CE, Moore JM, et al. : The use of single stent-assisted coiling in treatment of bifurcation aneurysms: a multicenter cohort study with proposal of a scoring system to predict complete occlusion. Neurosurgery 82 : 710-718, 2018 https://doi.org/10.1093/neuros/nyx310
  2. Aguilar-Perez M, Kurre W, Fischer S, Bazner H, Henkes H : Coil occlusion of wide-neck bifurcation aneurysms assisted by a novel intra- to extra-aneurysmatic neck-bridging device (pCONus): initial experience. AJNR Am J Neuroradiol 35 : 965-971, 2014 https://doi.org/10.3174/ajnr.A3807
  3. Ahmed ME, Lum C, Lesiuk H, Iancu D, dos Santos M : Navigation of stents across communicating arteries for aneurysm embolization. Can J Neurol Sci 41 : 193-199, 2014 https://doi.org/10.1017/s0317167100016577
  4. Aydin K, Balci S, Sencer S, Barburoglu M, Umutlu MR, Arat A : Y-stent-assisted coiling with low-profile neuroform atlas stents for endovascular treatment of wide-necked complex intracranial bifurcation aneurysms. Neurosurgery 87 : 744-753, 2020 https://doi.org/10.1093/neuros/nyz516
  5. Aydin K, Men S, Barburoglu M, Sencer S, Akpek S : Initial and Long-term outcomes of complex bifurcation aneurysms treated by Y-stent-assisted coiling with low-profile braided stents. AJNR Am J Neuroradiol 39 : 2284-2290, 2018 https://doi.org/10.3174/ajnr.A5869
  6. Aydin K, Sencer S, Barburoglu M, Berdikhojayev M, Aras Y, Sencer A, et al. : Midterm results of T-stent-assisted coiling of wide-necked and complex intracranial bifurcation aneurysms using low-profile stents. J Neurosurg 127 : 1288-1296, 2017 https://doi.org/10.3171/2016.9.jns161909
  7. Aydin K, Stracke CP, Barburoglu M, Yamac E, Berdikhojayev M, Sencer S, et al. : Long-term outcomes of wide-necked intracranial bifurcation aneurysms treated with T-stent-assisted coiling. J Neurosurg 134 : 39-48, 2021 https://doi.org/10.3171/2019.9.JNS191733
  8. Bartolini B, Blanc R, Pistocchi S, Redjem H, Piotin M : "Y" and "X" stent-assisted coiling of complex and wide-neck intracranial bifurcation aneurysms. AJNR Am J Neuroradiol 35 : 2153-2158, 2014 https://doi.org/10.3174/ajnr.A4060
  9. Cagnazzo F, Limbucci N, Nappini S, Renieri L, Rosi A, Laiso A, et al. : Y-stent-assisted coiling of wide-neck bifurcation intracranial aneurysms: a meta-analysis. AJNR Am J Neuroradiol 40 : 122-128, 2019 https://doi.org/10.3174/ajnr.A5900
  10. Choi HH, Cho YD, Yoo DH, Ahn SJ, Cho WS, Kang HS, et al. : Stent-assisted coil embolization of anterior communicating artery aneurysms: safety, effectiveness, and risk factors for procedural complications or recanalization. J Neurointerv Surg 11 : 49-56, 2019 https://doi.org/10.1136/neurintsurg-2018-013943
  11. Choi HH, Cho YD, Yoo DH, Lee SH, Yeon EK, Kang HS, et al. : Safety and efficacy of anterior communicating artery compromise during endovascular coil embolization of adjoining aneurysms. J Neurosurg 132 : 1068-1076, 2019 https://doi.org/10.3171/2018.11.jns181929
  12. Ciccio G, Robert T, Smajda S, Fahed R, Desilles JP, Redjem H, et al. : Double stent assisted coiling of intracranial bifurcation aneurysms in Y and X configurations with the Neuroform ATLAS stent: immediate and mid term angiographic and clinical follow-up. J Neurointerv Surg 11 : 1239-1242, 2019 https://doi.org/10.1136/neurintsurg-2019-015175
  13. Du EHY, Shankar JJS : LVIS Jr 'shelf' technique: an alternative to Y stent-assisted aneurysm coiling. J Neurointerv Surg 8 : 1256-1259, 2016 https://doi.org/10.1136/neurintsurg-2015-012246
  14. Fargen KM, Mocco J, Neal D, Dewan MC, Reavey-Cantwell J, Woo HH, et al. : A multicenter study of stent-assisted coiling of cerebral aneurysms with a Y configuration. Neurosurgery 73 : 466-472, 2013 https://doi.org/10.1227/NEU.0000000000000015
  15. Gory B, Spiotta AM, Mangiafico S, Consoli A, Biondi A, Pomero E, et al. : PulseRider stent-assisted coiling of wide-neck bifurcation aneurysms: periprocedural results in an international series. AJNR Am J Neuroradiol 37 : 130-135, 2016 https://doi.org/10.3174/ajnr.A4506
  16. Guo XB, Yan BJ, Guan S : Waffle-cone technique using solitaire AB stent for endovascular treatment of complex and wide-necked bifurcation cerebral aneurysms. J Neuroimaging 24 : 599-602, 2014 https://doi.org/10.1111/jon.12121
  17. Hassan T, Elsayed A, Abbas M, Sultan A, Eladawy Y : Proposed parent vessel geometry based classification of anterior communicating artery-located aneurysms. World Neurosurg 101 : 259-269, 2017 https://doi.org/10.1016/j.wneu.2017.01.096
  18. Huang Q, Xu Y, Hong B, Zhao R, Zhao W, Liu J : Stent-assisted embolization of wide-neck anterior communicating artery aneurysms: review of 21 consecutive cases. AJNR Am J Neuroradiol 30 : 1502-1506, 2009 https://doi.org/10.3174/ajnr.A1618
  19. Kwon HJ, Lim JW, Byoun HS, Koh HS : Novel noncrossing Y-stent technique using tapered proximal end of a solitaire AB stent for coil embolization of wide-neck bifurcation aneurysms. J Korean Neurosurg Soc 64 : 136-141, 2021 https://doi.org/10.3340/jkns.2019.0253
  20. Lescher S, du Mesnil de Rochemont R, Berkefeld J : Woven Endobridge (WEB) device for endovascular treatment of complex unruptured aneurysms-a single center experience. Neuroradiology 58 : 383-390, 2016 https://doi.org/10.1007/s00234-016-1641-x
  21. 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
  22. Raslan AM, Oztaskin M, Thompson EM, Dogan A, Petersen B, Nesbit G, et al. : Neuroform stent-assisted embolization of incidental anterior communicating artery aneurysms: long-term clinical and angiographic follow-up. Neurosurgery 69 : 27-37; discussion 37, 2011 https://doi.org/10.1227/NEU.0b013e31820edbb6
  23. Roy D, Milot G, Raymond J : Endovascular treatment of unruptured aneurysms. Stroke 32 : 1998-2004, 2001 https://doi.org/10.1161/hs0901.095600
  24. Yasargil MG : Microsurgery II. Anterior Cerebral and Anterior Communicating Artery Aneurysms. Stuttgart : Geroge Thieme Verlag, 1984
  25. Zhang XJ, Gao BL, Hao WL, Wu SS, Zhang DH : Presence of anterior communicating artery aneurysm is associated with age, bifurcation angle, and vessel diameter. Stroke 49 : 341-347, 2018 https://doi.org/10.1161/STROKEAHA.117.019701