Crossing Y-stent technique with dual open-cell stents for coiling of wide-necked bifurcation aneurysms

Ko, Jun Kyeung; Han, In Ho; Cho, Won Ho; Choi, Byung Kwan; Heon, Seung; Choi, Chang Hwa; Lee, Sang Weon; Lee, Tae Hong

doi:10.1016/j.clineuro.2015.02.002

Cited by 25 publications

(9 citation statements)

References 28 publications

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“…This underlines the importance of proper antiaggregation before Y-stenting. Ko et al [35] and other authors [5, 10, 13, 15-17, 25, 40] have reported a complete resolution of procedure-related thromboembolic events after IA infusion of GPIs. The use of low-profile stents in vessels ≤2 mm may prompt the use of intravenous GPI infusions as part of the operative protocol to avoid thromboembolic complications.…”

Section: Discussionmentioning

confidence: 97%

“…Most of these complications are related to thromboembolic events. Ko et al [35] described a 25% rate of acute IST in a series in which most patients (15/20) were treated with Y-stenting after failure of other neck remodeling techniques (balloon remodeling or single stenting). This underlines the importance of proper antiaggregation before Y-stenting.…”

Section: Discussionmentioning

confidence: 99%

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LVIS Jr Device for Y-Stent-Assisted Coil Embolization of Wide-Neck Intracranial Aneurysms: A Multicenter Experience

et al. 2018

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Background and Purpose: Complex wide-neck intracranial aneurysms are challenging to treat. We report a multicenter experience using the LVIS Jr stent for “Y-stent”-assisted coiling embolization of wide-neck bifurcation aneurysms. Methods: Seven centers provided retrospective data on patients who underwent Y-stenting. Technical complications, immediate posttreatment angiographic results, clinical outcomes, and imaging follow-up were assessed. Results: Thirty patients/aneurysms were treated: 15 basilar tip, 8 middle cerebral artery, 4 anterior communicating artery, 1 pericallosal, and 2 posterior inferior cerebellar artery aneurysms. The mean aneurysm size was 11 mm and the mean dome-to-neck ratio was 1.3 mm. Twenty-four aneurysms were unruptured and treated electively, and 6 were acutely ruptured. Fifty-eight LVIS Jr stents were successfully deployed without any technical issue. One procedural and transient in-stent thrombosis resolved with the intravenous infusion of a glycoprotein IIb/IIIa inhibitor. Five periprocedural complications (within 30 days) occurred: 2 periprocedural neurological complications (1 small temporal stroke that presented with transient aphasia and 1 posterior cerebral artery infarct) and 3 nonneurological periprocedural complications (2 retroperitoneal hematomas, and 1 patient developed a disseminated intravascular coagulopathy). One permanent complication (3.3%) directly related to Y-stenting was reported in the patient who suffered the posterior cerebral artery infarct. Immediate complete obliteration (Raymond-Roy Occlusion Classification [RROC] I–II) was achieved in 26 cases (89.6%). Twenty-four patients had clinical and imaging follow-up (mean 5.2 months). Complete angiographic occlusion (RROC I–II) was observed in 23 patients (96%). A good functional outcome with a modified Rankin Scale score ≤2 was achieved in 26 cases. Conclusions: In this multicenter case series, Y-stent-assisted coiling of wide-neck aneurysms with the LVIS Jr device was feasible and relatively safe. Follow-up imaging demonstrated very low recanalization rates.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

LVIS Jr Device for Y-Stent-Assisted Coil Embolization of Wide-Neck Intracranial Aneurysms: A Multicenter Experience

et al. 2018

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“…[1][2][3][4][5] Even in the era of endoluminal and intrasaccular flow diverters, many wide-neck and wide-neck bifurcation aneurysms will continue to be treated with conventional coiling, particularly with stent assistance. [6][7][8] We present the results of a systematic review and metaanalysis examining outcomes of endovascular coiling of wideneck and wide-neck bifurcation aneurysms with and without stent-assisted coiling. The aim of our study was to assess both angiographic and clinical outcomes in order to provide overall data against which current and future emergent techniques can be compared.…”

mentioning

confidence: 99%

Endovascular Coiling of Wide-Neck and Wide-Neck Bifurcation Aneurysms: A Systematic Review and Meta-Analysis

Zhao¹,

Yin

Lanzino³

et al. 2016

AJNR Am J Neuroradiol

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“…In the crossing-Y configuration, the first stent is placed from one distal bifurcation branch to the parent artery. A second stent is advanced from the other bifurcation branch through the interstices of the first deployed stent in the parent artery, overlapping the first stent 4. In the non-overlapping Y-stenting technique, the second stent is placed from the bifurcation to one bifurcation branch without overlapping the first stent 5.…”

Section: Introductionmentioning

confidence: 99%

Vascular angular remodeling by kissing-Y stenting in wide necked intracranial bifurcation aneurysms

Melber

Meila

Draheim

et al. 2016

J NeuroIntervent Surg

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Crossing Y-stent technique with dual open-cell stents for coiling of wide-necked bifurcation aneurysms

Cited by 25 publications

References 28 publications

LVIS Jr Device for Y-Stent-Assisted Coil Embolization of Wide-Neck Intracranial Aneurysms: A Multicenter Experience

LVIS Jr Device for Y-Stent-Assisted Coil Embolization of Wide-Neck Intracranial Aneurysms: A Multicenter Experience

Endovascular Coiling of Wide-Neck and Wide-Neck Bifurcation Aneurysms: A Systematic Review and Meta-Analysis

Vascular angular remodeling by kissing-Y stenting in wide necked intracranial bifurcation aneurysms

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