scholarly journals Stent-Assisted Coiling of Wide-Neck Intracranial Aneurysms Using Low-Profile LEO Baby Stents: Initial and Midterm Results

2015 ◽  
Vol 36 (10) ◽  
pp. 1934-1941 ◽  
Author(s):  
K. Aydin ◽  
A. Arat ◽  
S. Sencer ◽  
M. Barburoglu ◽  
S. Men
Keyword(s):  
Intracranial Aneurysms ◽  
Midterm Results ◽  
Low Profile ◽  
Wide Neck

The low-profile Neuroform Atlas stent in the treatment of wide-necked intracranial aneurysms – immediate and midterm results: An Italian multicenter registry

2020 ◽  
Vol 47 (6) ◽  
pp. 421-427 ◽  
Author(s):  
Antonio A. Caragliano ◽  
Rosario Papa ◽  
Antonio Pitrone ◽  
Nicola Limbucci ◽  
Sergio Nappini ◽  
...  
Keyword(s):  
Intracranial Aneurysms ◽  
Midterm Results ◽  
Low Profile ◽  
Multicenter Registry

scholarly journals Y-Stent-Assisted Coil Embolization of Wide-Neck Intracranial Aneurysms

2011 ◽  
Vol 17 (1) ◽  
pp. 36-48 ◽  
Author(s):  
E. Akgul ◽  
E. Aksungur ◽  
T. Balli ◽  
B. Onan ◽  
D.M. Yilmaz ◽  
...  
Keyword(s):  
Coil Embolization ◽  
Intracranial Aneurysms ◽  
Neurological Complications ◽  
Anterior Communicating Artery ◽  
Hybrid Technique ◽  
Treatment Technique ◽  
Midterm Results ◽  
Procedural Complication ◽  
Wide Neck

This report evaluated the short and midterm results of the safety and effectiveness of the treatment technique with hybrid and non-hybrid Y-configured, dual stent-assisted coil embolization of wide-neck intracranial aneurysms, and reviewed the literature concerning this technique. Nine patients, eight with unruptured and one with ruptured aneurysms were included in the study. Of aneurysms embolized with a hybrid (with two different stents) and non-hybrid (with two identical stents) technique, three were located in the anterior communicating artery, three at the tip and one at the distal site of basilar artery, and two in the middle cerebral artery. All aneurysms included the orifices of bifurcation vessels. All aneurysms were stented and embolized during the same session. While Neuroform and Enterprise stents were used in the hybrid technique, two Enterprise stents were used in the non-hybrid technique. Dual Y-stent assisted coil embolization was performed successfully in eight of nine patients (88.9%), including five patients (55.6%) with hybrid and three patients (33.3%) with non-hybrid technique. No procedural complication, no mortality and no minor or major neurological complications were seen during the angiographic or clinical follow-up. When an attempt was made at passing the second stent through the first Enterprise stent, the stent protruded inside the aneurysm in one patient (11.1%). Hybrid or non-hybrid dual Y-stent-assisted coil embolization in the treatment of ruptured or unruptured wide-neck and complex intracranial aneurysms is a safe and effective method from the viewpoint of short and midterm results.

Feasibility and Efficacy of Low-profile Visual Intraluminal Support Device: a Single Center Five-year Experience

2021 ◽  
Vol 18 ◽  
Author(s):  
Vitaliy Davidov ◽  
Saeed Sadrameli ◽  
Virendra Desai ◽  
Jonathan Lee ◽  
Ryan Austerman ◽  
...  
Keyword(s):  
Intracranial Aneurysms ◽  
Anterior Communicating Artery ◽  
High Porosity ◽  
Common Location ◽  
Low Profile ◽  
Support Device ◽  
The Mean ◽  
New Generation ◽  
Wide Neck

Introduction: The Low-Profile Visualized Intraluminal Support (LVIS) devices are a new generation of self-expandable, high-porosity stents approved for the treatment of large to giant wide-necked intracranial aneurysms via stent-assisted coiling. Here we report the radiographic and clinical outcomes seen with LVIS, LVIS Jr. and LVIS Blue from a single institution over a five-year period. Methods: Patients with intracranial aneurysms treated by LVIS, LVIS Jr. and LVIS Blue technology over a five-year period (2012 - 2017) at our institution were retrospectively reviewed. Results: Seventy-four patients (55 females and 19 males; average age = 59.2) with 74 aneurysms underwent embolization of intracranial aneurysms using LVIS (N =10), LVIS Jr. (N = 47) or LVIS Blue (N =12) devices at our institution over the study period. The most common location of treated aneurysms was the anterior communicating artery (31%), followed by the basilar artery (19%), and the middle cerebral artery (13%). The mean neck and dome sizes were 3.9±1.5mm and 6.6±3.2mm, respectively. The median follow-up time was 6 months. At the last radiographic follow-up, 93.1% of patients had complete occlusion (RR-I or OKM-D). In 5 cases (7%), the LVIS stent failed to open, requiring balloon angioplasty (N=3) or stent recapture and use of a non-LVIS branded device (N=2). Five patients had post-embolization infarcts, and 1 patient had an intra-operative dome rupture. Conclusion: LVIS brand of stents is a safe, effective, and technically feasible treatment strategy for wide-neck intracranial aneurysms, with high deployment success and aneurysm obliteration rates.

Outcomes following aneurysmal coil embolization with intentionally shortened low-profile visible intraluminal support stent deployment

2021 ◽  
pp. 197140092110269
Author(s):  
Kenji Yatomi ◽  
Yumiko Mitome-Mishima ◽  
Takashi Fujii ◽  
Kohsuke Teranishi ◽  
Hidenori Oishi ◽  
...  
Keyword(s):  
Fluid Dynamics ◽  
Computational Fluid Dynamics ◽  
Coil Embolization ◽  
Intracranial Aneurysms ◽  
Perioperative Complications ◽  
Flow Diversion ◽  
Stent Deployment ◽  
Coverage Ratio ◽  
Low Profile ◽  
Unruptured Intracranial Aneurysms

Purpose Among all stents available for neuroendovascular therapy, the low-profile visible intraluminal support stent bears the highest metal coverage ratio. We deployed a low-profile visible intraluminal support stent with a delivery wire or/and microcatheter system push action to shorten the low-profile visible intraluminal support stent and thus achieve a flow diversion effect. We report our single-institution experience with the use of low-profile visible intraluminal support stents for intentionally shortened deployment (shortening group) and non-shortened deployment (non-shortening group) for unruptured intracranial aneurysms. Methods We retrospectively reviewed the medical records of 130 patients with 131 intracranial aneurysms who were treated with low-profile visible intraluminal support stent-assisted coil embolization from February 2016–January 2019. All perioperative complications were noted. Every 6 months, we re-examined the patients with cerebral angiography or magnetic resonance angiography. The outcomes of aneurysm occlusion were evaluated by the modified Raymond–Roy occlusion classification. We used the finite element method and computational fluid dynamics to investigate the hemodynamics after shortened low-profile visible intraluminal support stent deployment. Results Immediately after treatment, the modified Raymond-Roy occlusion classification was significantly better in the shortening group than in the non-shortening group ( p<0.05). The latest angiographic outcomes showed the same tendency. Hemodynamic analysis by computational fluid dynamics suggested an adequate flow diversion effect with the use of our intentional shortening method. Conclusions Stent-assisted coil embolization using this technique showed good results of a high complete occlusion rate and low complication rate. These findings suggest that shortened low-profile visible intraluminal support stent deployment yields a flow diversion effect and may lead to early intra-aneurysmal thrombus formation.

Improved Endovascular Coiling of Wide-Neck Intracranial Aneurysms in Elderly Patients by Double-Microcatheter Technique

2014 ◽  
Vol 71 (3) ◽  
pp. 1281-1286 ◽  
Author(s):  
Xiang Xu ◽  
Yu Zheng ◽  
Dayong Wang ◽  
Jianzhong Cui ◽  
Xiaoming Shang
Keyword(s):  
Elderly Patients ◽  
Intracranial Aneurysms ◽  
Endovascular Coiling ◽  
Wide Neck

Medina embolization device for the treatment of intracranial aneurysms: 18 months’ angiographic results

2018 ◽  
Vol 11 (5) ◽  
pp. 516-522 ◽  
Author(s):  
Idriss Haffaf ◽  
Frédéric Clarençon ◽  
Eimad Shotar ◽  
Claudia Rolla-Bigliani ◽  
Saskia Vande Perre ◽  
...  
Keyword(s):  
Intracranial Aneurysms ◽  
Thromboembolic Complication ◽  
Detachable Coil ◽  
Mean Delay ◽  
Scale Scores ◽  
Long Term Follow Up ◽  
Occlusion Rate ◽  
Wide Neck

Background and purposeThe Medina embolization device (MED) is a new flow disruption device combining the design of a detachable coil with an intrasaccular flow disrupter. Safety and short-term angiographic effectiveness of this device have recently been reported. However, long-term angiographic results are lacking. We report herein the 18 months’ angiographic outcome in patients treated for a wide-neck intracranial aneurysm with the MED.Materials and methodsNineteen patients (17 female, mean age 50 years) with 20 wide-neck intracranial aneurysms (six ruptured; 14 unruptured) were treated by the MED between January 2015 and June 2016. Procedure-related complications were systematically recorded; discharge and 6–9 months' follow-up modified Rankin Scale scores were assessed. Angiographic mid-term and long-term follow-up were performed with a mean delay of 6.4±1.5 months (n=16 aneurysms) and 17.7±4.2 months (n=15 aneurysms), respectively. Occlusion rates were evaluated after the procedure and at the mid-term and long-term follow-up using the Roy-Raymond scale.ResultsEmbolization with the MED was feasible in all except two cases (2/20, 10%). One per-procedural perforation was recorded (1/20, 5%) and one MED deployment failed because of the aneurysm’s shape (1/20, 5%). Three cases of thromboembolic complications were observed (3/20, 15%). Only one thromboembolic complication was responsible for clinical sequelae. Grade A occlusion rate was 61% (11/18) after the procedure, 75% at 6 months' follow-up (12/16), and 80% (12/15) at long-term follow-up. Two cases (2/18, 11%) of recanalization at mid-term were documented angiographically. No recanalization occurred between the mid-term and long-term follow-up.ConclusionMED is a hybrid embolization device, combining properties of a conventional coil with those of an intrasaccular flow disrupter. Our series focusing on long-term angiographic follow-up shows a satisfactory long-term occlusion rate. Larger series with longer angiographic follow-up times are warranted to confirm these preliminary results.

scholarly journals Stent-assisted coiling of unruptured intracranial aneurysms with wide neck

2020 ◽  
Vol 15 (4) ◽  
pp. 821
Author(s):  
ConstantineNikolaos Antonopoulos ◽  
Filippos Papadopoulos ◽  
George Geroulakos
Keyword(s):  
Intracranial Aneurysms ◽  
Unruptured Intracranial Aneurysms ◽  
Wide Neck

scholarly journals Dual microcatheter technique for the treatment of a ruptured wide neck basilar tip aneurysm

2019 ◽  
pp. 116-121
Author(s):  
Rares Filep ◽  
Dorin Nicolae Gherasim ◽  
Septimiu Popescu ◽  
Botond Tokes ◽  
Lucian Marginean
Keyword(s):  
Intracranial Aneurysms ◽  
Therapeutic Option ◽  
Intraventricular Haemorrhage ◽  
Acute Onset ◽  
Alternative Methods ◽  
Neurological Deficits ◽  
Complication Rates ◽  
Unruptured Intracranial Aneurysms ◽  
Basilar Tip Aneurysm ◽  
Wide Neck

Endovascular treatment is a safe and efficient therapy for intracranial aneurysms with lower complication and mortality rates compared to surgical clipping. Wide-neck aneurysms still represent a challenge to complete and safe aneurysm occlusion in spite of techniques such as stent-assisted or balloon-assisted coiling, developed in order to achieve better occlusion rates. These techniques themselves may lead to further complications, so alternative methods such as the dual microcatheter technique were developed. This technique assumes that, via two microcatheters inserted into an aneurysm, simultaneous deployment of two coils achieves a stable coil frame without the use of adjunctive devices. The aim of this paper is to present a successfully treated basilar tip wide-neck aneurysm treated with the dual microcatheter technique.Case report. A 46-year-old male patient with acute onset of severe headache presented in the emergency room with altered state of consciousness. Non-enhanced CT scan showed subarachnoid and intraventricular haemorrhage. CT angiography revealed a wide-neck basilar tip aneurysm. Digital subtraction angiography confirmed the presence of an aneurysm with a wide, 4.9 mm neck.Dual microcatheter technique was chosen as the first treatment option, while a hypercompliant balloon was kept as backup. Two microcatheters were placed inside de aneurysm and two coils were introduced in order to form a stable framing coil mass that served as a support for further coils deployed in an alternately manner through each microcatheter. No procedural complication occurred, and the patient’s evolution was uneventful with no neurological deficits at discharge.Conclusion. The dual microcatheter technique is a safe and effective therapeutic option for wide-neck ruptured or unruptured intracranial aneurysms. Periprocedural complication rates are similar to simple coiling or balloon-assisted coiling, but lower than for stent-assisted coiling.

scholarly journals Treatment of Wide-Neck Intracranial Aneurysms with the Woven EndoBridge Device Associated with Stenting: A Single-Center Experience

2019 ◽  
Vol 40 (5) ◽  
pp. 820-826 ◽  
Author(s):  
F. Cagnazzo ◽  
R. Ahmed ◽  
C. Dargazanli ◽  
P.-H. Lefevre ◽  
G. Gascou ◽  
...  
Keyword(s):  
Intracranial Aneurysms ◽  
Single Center ◽  
Single Center Experience ◽  
Woven Endobridge ◽  
Wide Neck
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