Conventional endovascular treatment may have limitations for vertebral dissecting aneurysm involving the origin of the posterior inferior cerebellar artery (PICA). We report our experiences of treating vertebral dissecting aneurysm with PICA origin involvement by placing a stent from the distal vertebral artery (VA) to the PICA to save the patency of the PICA. Stenting from the distal VA to the PICA was attempted to treat ruptured VA dissecting aneurysm involving the PICA origin with sufficient contralateral VA in eight patients. The procedure was successfully performed in seven patients with one failure because of PICA origin stenosis, which was treated with two overlapping stents. In the seven patients, PICAs had good patency on postoperative angiography and transient lateral brainstem ischemia represents a procedure-related complication. Follow-up angiographies were performed in seven patients and showed recanalization of the distal VA in three patients without evidence of aneurysmal filling. There was no evidence of aneurysm rupture during the follow-up period, and eight patients had favorable outcomes (mRS, 0–1). Placing a stent from the distal VA to the PICA with VA occlusion may present an alternative to conventional endovascular treatment for vertebral dissecting aneurysm with PICA origin involvement with sufficient contralateral VA.

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AIm: To describe a reconstructive technique using single stent for wide-necked aneurysms. mAterIAl and methOds: This technique was described as stent-jail technique consisting of the aneurismal catheterization before the deployment of a self-expandable stent across the aneurysm neck. Following the deployment of the stent, embolization coils were delivered with the microcatheter positioned within the aneurysm dome and wedged between the stent and the aneurysm dome. The microstents, such as Neuroform, Leo and Wingspan stents, were used in in our series for electively treated aneurysms.results: During a 3-year period,13 patients with wide-necked aneurysms were treated electively with this technique. The aneurysms arose from the internal carotid artery (5), anterior cerebral artery (4), anterior communicating artery (1), vertebral artery ( 1), middle cerebral artery (1) and middle cerebral artery (1). Thirteen stents (6 Leo stents, 4 Neuroform stents and 3 Wingspan stents) were successfully deployed across the aneurysm neck to constrain subsequent embolization coils of a wide-necked cerebral aneurysm. None of the patients experienced any periprocedural or delayed neurological complications. This maneuver enabled us to support the coil loops within the aneurismal sac with stabilization of the microcatheter. COnClusIOn:The stent-jail technique represents an efficacious adjuvant technique to assist coiling of selected wide-necked cerebral aneurysms. This technique is particularly helpful for wide-necked aneurysms.KeywOrds: Aneurysm, Stent, Endovascular ÖZ AmAÇ: Geniş boyunlu anevrizmalarda tek stent kullanarak rekonstrüktif bir tekniği tanımlamak. yÖntem ve GereÇler: Bu teknik anevrizma boynu içinde kendiliğinden genişleyen bir stentin yerine yerleştirilmesinden önce anevrizmal kateterizasyondan oluşan stent-jail tekniği olarak tanımlanmıştır. Stent yerine yerleştirilmesinden sonra anevrizma kubbesi içinde konumlandırılan mikrokateterle embolizasyon sarmalları iletilmiş ve stent ile anevrizma kubbesi arasına kama şeklinde sokulmuştur. Neuroform, Leo ve Wingspan stentleri gibi mikrostentler serimizde elektif olarak tedavi edilen anevrizmalar için kullanılmışlardır.BulGulAr: 3 yıllık bir dönemde bu teknik ile geniş boyunlu anevrizması olan 13 hasta elektif olarak tedavi edilmiştir. Anevrizmaların kökeni internal karotid arter (5), anterior serebral arter (4), anterior kommunikan arter (1), vertebral arter (1), orta serebral arter (1) ve orta serebral arter (1) olmuştur. On üç stent (6 Leo stenti, 4 Neuroform stent ve 3 Wingspan stenti) geniş boyunlu serebral anevrizmada daha sonraki embolizasyon sarmallarını sınırlandırmak üzere anevrizma boynu içinde başarılı şekilde yerine yerleştirilmiştir. Hastaların hiçbiri işlem sırasında veya gecikmiş nörolojik komplikasyon yaşamamıştır. Bu manevra sarmal halkalarını mikrokateter stabilizasyonuyla anevrizma kesesi içinde desteklememizi mümkün kılmıştır.sOnuÇ: Stent-jail tekniği seçilen geniş boyunlu serebral anevrizmalarda sarmal konmasına yardımcı olmak üzere etkin bir ya...