Mid-term Results of Endovascular Coiling of Wide-Necked Aneurysms Using Double Stents in a Y Configuration

Abstract

Y-stent reconstruction enables the endovascular management of otherwise complex, wide-necked cerebral aneurysms and can be performed safely in experienced hands with satisfactory mid-term results, even in cases requiring retreatment.

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

“…These excellent results demonstrated the efficacy and durability of the Y-stent technique for intracranial bifurcation aneurysms, which coincided with the findings in recently published literature. 21,22 In this series, the success rate of the techniques associated with the crossing-Y or kissing-Y stent was 100%. Although a thrombus event (1/11) resulting from a coil loop protrusion was encountered in case 2 (Fig 1), a salvaging Y-stent was used, achieving the patency of double branches.…”

Complication analysis in nitinol stent-assisted embolization of 486 intracranial aneurysms

“…Results from several smaller series have suggested efficacy and safety with the use of overlapping-stent constructs. 3,8,30 Chalouhi et al 4 reported no complications in 28 patients with overlapping stents. Our study may include the largest series of overlapping-stent treatments for aneurysms.…”

“…1 Fargen et al 8 combined the single-center experiences of 7 institutions and found that among 45 patients treated with Y-configuration stenting, 3 (7.5%) of 40 had a modified Rankin Scale score of ≥ 3 at follow-up. Spiotta et al 30 reported 4 clinically significant strokes in a series of 19 patients with Y-stented aneurysms, 3 (15.8%) of which seemed to be major complications. Chalouhi et al 5 reported 1 significant complication (6.3%) in 16 basilar tip aneurysms treated with Y-configuration stenting.…”

“…Complex stent configurations, including Y configurations, have been used to treat aneurysms located at bifurcations and aneurysms with necks that incorporate significant portions of both daughter vessels. 18,30 Overlapping stent arrangements have been used to bridge aneurysms with fusiform morphology and very wide necks to reinforce inadequate single stents and to enhance flow diversion. 1,3,32 Despite the improved vessel reconstruction, potential complications with multistent constructs remain a topic of great interest to neurointerventional surgeons.…”

Hemodynamics of 8 Different Configurations of Stenting for Bifurcation Aneurysms

“…In addition, various configurations of stentings have been proposed and performed for bifurcation aneurysms, including a single stent from a proximal to a distal vessel; a waffle-cone stent 6 ; a horizontal stent [7][8][9] ; a nonoverlapping-Y stent 10 ; a kissing (double-barrel) Y stent, in which both stents are deployed in a parallel fashion 11,12 ; and a crossing-Y stent, in which the second stent is deployed through the interstices of the first stent. [12][13][14][15][16][17][18] The differences in hemodynamics among these various configurations of stent placement are unclear, and this may be important for the recanalization rate. In crossing-Y stents, use of double closed-cell stents causes narrowing of the second stent through the interstices of the first stent, 17 while using an open-cell stent as the first stent can avoid this effect of narrowing.…”