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 language | English (US) |
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Pages (from-to) | 1035-1039 |
Number of pages | 5 |
Journal | Neurosurgery |
Volume | 56 |
Issue number | 5 |
DOIs | |
State | Published - May 2005 |
Externally published | Yes |
Keywords
- Aneurysms
- Basilar artery
- Coil embolization
- Intracranial stent
- Stent
ASJC Scopus subject areas
- Surgery
- Clinical Neurology