Endovascular Treatment of Wide-Neck Middle Cerebral Artery Aneurysms with Stents: A Review of 16 Cases

Abstract

BACKGROUND AND PURPOSE: MCA aneurysms are common and often pose technical challenges to interventionalists. Intracranial stents are widely used in treating wide-neck aneurysms in other locations. To evaluate the feasibility, effectiveness, and safety of stent placement in MCA aneurysms, we performed this retrospective study.

Aneurysm treatment in Europe 2010: an internet survey

“…This is similar to the findings in respect of ruptured MCA aneurysms, which showed a significant difference even in coiling. Although some recent reports show good results in the treatment of MCA aneurysms by coiling [3,7,13,14], our results suggest that surgical clipping remains the "gold standard" of MCA aneurysm treatment [4][5][6].…”

Y-Configuration Stent Placement (Crossing and Kissing) for Endovascular Treatment of Wide-Neck Cerebral Aneurysms Located at 4 Different Bifurcation Sites

“…Generally, a single stent provided us the protection of 2 branches of wide-neck bifurcation aneurysms. Occasionally, the protrusion of a coil loop or coil mass 19 might affect the other branch blood flow, resulting in the salvaging Y-stent implantation.…”

“…However, we en- countered significant difficulty in the first 2 cases (cases 3 and 4) while delivering the second stent through the interstices of the first Neuroform stent, as we previously reported. 19 During the same period, we had performed 4 unplanned Y-stent techniques without any difficulty, for which the first and second choices were both Enterprise stents (cases 2 and 5-7). These experiences indicate that the use of the Enterprise stent may ease the catheterization, delivery, and deployment of the Yconfiguration stent implantation.…”

“Y” and “X” Stent-Assisted Coiling of Complex and Wide-Neck Intracranial Bifurcation Aneurysms

“…Recently, the treatment of wide-neck intracranial aneurysms with self-expandable intracranial stents has also been reported to be feasible and effective in many clinical series [2][3][4][5][6] at bifurcation sites, [7][8][9] at the price of an increased risk of thromboembolic and ischemic complications compared with coiling. 10 Unfortunately, endovascular treatment of complex or wide-neck bifurcation aneurysms still remains a challenge for the endovascular surgeon.…”