Y-configured dual intracranial stent-assisted coil embolization for the treatment of wide-necked basilar tip aneurysms

William E. Thorell, Michael M. Chow, Henry H. Woo, Thomas J. Masaryk, Peter A. Rasmussen

Research output: Contribution to journalArticle

85 Scopus citations

Abstract

OBJECTIVE: Despite advances in both the surgical and endovascular treatment of intracranial aneurysms, wide-necked basilar tip aneurysms (i.e., basilar tip aneurysms in which both posterior cerebral arteries emanate from the base of a wide-necked aneurysm) represent a subset of aneurysms that continues to pose technical challenges in treatment. We sought to demonstrate the safety and short-term durability of a novel dual stent-assisted coil embolization technique. METHODS: Two Neuroform stents (Boston Scientific/Target, Fremont, CA) were deployed in the posterior cerebral arteries and the basilar artery, one passing through the interstices of the other in a Y-configuration, thereby recreating an aneurysm neck and enabling safe coil delivery while preserving the parent vessels. RESULTS: Seven patients with unruptured, asymptomatic, wide-necked basilar tip aneurysms involving both posterior cerebral arteries and ranging in size from 7 to 20 mm underwent treatment with this stent-assisted coiling technique. Two stents were successfully deployed in six of the patients and one stent was successfully deployed in the seventh. One patient developed a transient internuclear ophthalmoplegia, and another experienced transient partial right oculomotor nerve palsy. All aneurysms had complete or near-complete embolization with the initial procedure. Follow-up angiography performed 6 months (six patients) and 1 year (one patient) after treatment demonstrated coil compaction and slight recanalization in one patient and recanalization requiring retreatment in another. All patients were neurologically intact at least 6 months after the initial procedure, as well as subsequent procedures, without clinical signs of subarachnoid hemorrhage. CONCLUSION: These initial technical and clinical results are highly encouraging, and this technique may significantly improve the endovascular treatment of intracranial aneurysms.

Original languageEnglish (US)
Pages (from-to)1035-1039
Number of pages5
JournalNeurosurgery
Volume56
Issue number5
DOIs
StatePublished - May 1 2005

Keywords

  • Aneurysms
  • Basilar artery
  • Coil embolization
  • Intracranial stent
  • Stent

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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