Stent-Jack Technique in Stent-Assisted Coiling of Wide-Neck Aneurysms

Abstract

We found that the stentjack technique was helpful in the treatment of selective aneurysms with a dome-to-neck ratio smaller than 1.5.

Endovascular Treatment of Wide-Necked Intracranial Aneurysms : Techniques and Outcomes in 15 Patients

“…Wide-necked intracranial aneurysms represent one of the most unfavorable aneurysm configurations. Various devices and techniques have , multiple microcatheter 1,11,12) , balloon remodeling technique 17) , intracranial stents 6) , flow diverter devices 15) and neck-bridge device 5,19) . We aimed to identify the best choice for treatment of widenecked intracranial aneurysms.…”

“…Adjuvant stenting was proposed in the mid 1990's, initially for fusiform aneurysms 9) , and more recently to support the neck region of intracranial saccular aneurysms and to prevent recurrence 6,23,24) . An intracranial stent prevents coil migration or protrusion, enables dense packing in aneurysms, induces significant intra-aneurysmal flow modification, and provides a framework for endothelial growth resulting in permanent separation of the aneurysm from the parent vessel.…”

“…In wide-necked intracranial aneurysms, complete coil embolization is often technically difficult owing to the risks of distal coil migration or coil impingement on the parent vessel 4,7,8,10,21) . Various tools and techniques have been introduced to overcome these technical limitations including three-dimensional coils 3,22) , multiple microcatheter 1,11,12) , balloon-remodeling technique 14,17) , and intracranial stents 6,23,24) . However, the introduction of additional devices into small intracranial vessels is not only technically demanding, but also may increase the risk of vascular injury and thromboembolism.…”

“…When we failed to make a stable coil frame with two coils, we used a stent assisted-technique. These two techniques are not new concepts 1,6,11) . In this report, we present our experiences with 15 wide-necked intracranial aneurysms.…”

Endovascular Treatment of Middle Cerebral Artery Aneurysms for 120 Nonselected Patients: A Prospective Cohort Study

“…Stents were delivered after coiling in 47.4% (n ϭ 9; 5 Neuroform [Stryker Neurovascular, Kalamazoo, Michigan], 3 Enterprise [Codman & Shurtleff], 1 Wingspan [Stryker Neurovascular] stents), and before coiling in 52.6% (n ϭ 10). We used the jailing technique (n ϭ 8; 6 Neuroform and 2 Solitaire AB [Covidien, Irvine, California] stents), stent-jacking technique (n ϭ 1; 1 Solitaire AB stent), 17 and "Y" stent placement (n ϭ 1; 1 Neuroform stent and 1 Enterprise stent) when stents were placed before coiling. One ruptured aneurysm (1 of 19, 5.3%) was treated with a rescue stent.…”