A study from Turkey shows that successful and stable aneurysm occlusion can be achieved by a new endovascular treatment using two stents in a “Y” configuration. The technique avoids endosaccular packing.
The study was published in the August issue of the American Journal of Neuroradiology. Authors H Saruhan Cekirge and Kivilcim Yavuz with colleagues from the Department of Radiology, Hacettepe University Hospitals, Ankara, Turkey, have shown that the technical and clinical results achieved with the new flow-diversion technique are highly encouraging and that this technique may contribute to the endovascular treatment of complex bifurcation aneurysms.
There has been an increase in the use of stent-assisted endovascular treatment and flow diversion techniques in the management of wide-neck intracranial aneurysms. “We report our initial clinical experience using a new flow diversion technique for the endovascular management of bifurcation aneurysms,” the authors wrote.
Investigators treated eight bifurcation aneurysms by placing two stents in “Y”-configuration with no accompanying endosaccular packing.
This treatment technique aimed at flow diversion was selected in these cases because of the following reasons; the aneurysm was giant and causing mass effect; the emanating branches were incorporated within the sac; or the aneurysm was too small. Of the eight aneurysms treated with the technique, there were five aneurysms located at middle cerebral and three were located at basilar artery bifurcations. In terms of size, five aneurysms were small, one was large, and two were partially thrombosed giant aneurysms. Authors note that closed-cell stents were used in all Y-stent placement procedures.
- Results from the study showed that in all aneurysms, both stents could be placed at the intended locations without any procedural complication.
- Investigators also found that follow-up angiograms obtained from three months to two years revealed that all stents were patent barring one which had an asymptomatic P1 occlusion.
- All the middle cerebral artery bifurcation aneurysms and the large basilar tip aneurysm had complete occlusion with re-modelled bifurcation.
- There was residual filling, even though there was also a reduction in size in both of the partially thrombosed giant aneurysms at two-year and three-month follow-up angiograms, respectively.