Usefulness and problems of Y-Stent and T-Stent assisted coiling for unruptured cerebral aneurysms

Kuwajima, Takuto; Kaneda, Kiyoshi; Maruyama, Kosei; Yoshida, Shinichiro; Hama, Yoshiaki; Morita, Hiroya; Ota, Yuichiro; Tashiro, Noriaki; Hiraoka, Fumihiro; Kawano, Hiroto; Yano, Shigetoshi; Aikawa, Hiroshi; Go, Yoshinori; Yoshimura, Shinichi

doi:10.1016/j.jstrokecerebrovasdis.2022.106668

Cited by 2 publications

(5 citation statements)

References 10 publications

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“…Traditional endovascular treatment for wide-necked and bifurcation IAs mainly relies on coil embolization, but the effect of simple embolization treatment for them is not ideal, often requiring assistance such as balloons and stents ( Webb et al, 2022 ). Moreover, when only a single device is used to assist in the embolization of bifurcation IAs, the coil state is not stable, and is prone to move to the parent artery, leading to treatment failure ( Kuwajima et al, 2022 ; Webb et al, 2022 ). Therefore, multiple stents or balloons are commonly used in combination to treat bifurcation IAs ( Kuwajima et al, 2022 ) Although such a strategy can effectively treat bifurcation IAs due to the high occupancy of multiple devices in the host artery, it is easy to cause ischemic complications.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, when only a single device is used to assist in the embolization of bifurcation IAs, the coil state is not stable, and is prone to move to the parent artery, leading to treatment failure ( Kuwajima et al, 2022 ; Webb et al, 2022 ). Therefore, multiple stents or balloons are commonly used in combination to treat bifurcation IAs ( Kuwajima et al, 2022 ) Although such a strategy can effectively treat bifurcation IAs due to the high occupancy of multiple devices in the host artery, it is easy to cause ischemic complications. Therefore, administrating antiplatelet therapy during the periprocedural period becomes necessary, which sometimes makes it challenging to treat ruptured IAs effectively.…”

Section: Discussionmentioning

confidence: 99%

“…We included research articles on the treatment of IAs patients aged ≥ 18 years with Comaneci/Cascade devices. Exclude articles based on the following reasons: ( Barak et al, 2021 ) non-English articles; ( Claassen and Park, 2022 ) Case report; ( Philip et al, 2022 ) Less than 5 cases in the case series; ( Philip et al, 2022 ) Review or editorial articles; ( Webb et al, 2022 ) In vitro or animal research; ( Wang et al, 2016 ) Combining the use of other instruments to assist in embolization of aneurysms, such as balloons and stents ( Kuwajima et al, 2022 ). Other unrelated articles.…”

Section: Methodsmentioning

confidence: 99%

“…Although balloons can be used to treat ruptured IAs, meta-analysis shows that their occlusive effect is mostly inferior to stent therapy at 6 months or later after the procedure ( Wang et al, 2016 ). For bifurcation IAs people have always hoped for the combined application of multiple stents or balloons, which not only improves the occlusion rate of aneurysms, but also increases the incidence rate of ischemic complications ( Kuwajima et al, 2022 ). In recent years, intrasaccular flow disruption devices, mainly including Woven EndoBridge (WEB; MicroVention-Terumo, Aliso Viejo, CA, United States), have been invented specifically for the treatment of bifurcation IAs ( Hecker et al, 2023 ).…”

Section: Introductionmentioning

confidence: 99%

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A systematic review and meta-analysis of Comaneci/Cascade temporary neck bridging devices for the treatment of intracranial aneurysms

Sun,

Lan,

Sawant

et al. 2023

Front. Hum. Neurosci.

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BackgroundThe temporary neck bridging devices represented by Comaneci and Cascade are a type of promising endovascular device for the treatment of intracranial bifurcation or wide-necked aneurysms. This systematic review and meta-analysis aim to assess the efficacy and safety of Comaneci/Cascade devices for the treatment of intracranial aneurysms.MethodsWe performed a systematic literature search on articles in PubMed, Embase, and Web of Science that evaluated the efficacy and safety of Comaneci/Cascade devices for endovascular treatment of intracranial aneurysms, based on the Preferred Reporting Items for Systematic Reviews and Meta Analytics (PRISMA) guideline. We extracted the characteristics and treatment related information of patients included in the study, recorded the rate of technical success, procedural related complications, and angiographic outcomes. The angiographic outcome was evaluated based on Raymond Roy classification, and adequate occlusion was defined as Raymond Ray I + II.ResultsNine studies comprising 253 patients with 255 aneurysms were included. Among them, eight studies were conducted in Europe, one study was conducted in the USA. All these studies were retrospective. 206 aneurysms (80.78%) were ruptured. The vast majority of patients with ruptured aneurysms did not receive antiplatelet therapy. The rate of technical success was 97.1% (95% CI, 94.9 to 99.3%, I2 = 0%). The rate of periprocedural clinical complications was 10.9% (95% CI, 5.4 to 22.1%, I2 = 54%). The rate of complete occlusion (RR1) and adequate occlusion (RR1 + RR2) on immediate angiography after the procedure were 77.7% (95% CI, 72.7 to 83.2%, I2 = 35%) and 98% (95% CI, 95.9 to 100%, I2 = 0%) respectively. The rate of complete occlusion (RR1) and adequate occlusion (RR1 + RR2) on the last follow-up angiography were 81.2% (95% CI, 69.2 to 95.2%, I2 = 81%) and 93.7% (95% CI, 85.6 to 100%, I2 = 69%) respectively, with follow-up range from 3 to 18 months. 22/187 (11.76%) cases of aneurysms progressed during the follow-up period. 39/187 (20.86%) cases of aneurysms received additional treatment during the follow-up period. No fatal complications occurred during the treatment.ConclusionThe Comaneci/Cascade device can be used as an auxiliary treatment for intracranial aneurysms, with a good occlusion effect, but the incidence of complications still needs to be monitored.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A systematic review and meta-analysis of Comaneci/Cascade temporary neck bridging devices for the treatment of intracranial aneurysms

Sun,

Lan,

Sawant

et al. 2023

Front. Hum. Neurosci.

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“…However, even with this method, treatment is difficult when the PCoA originates far from the neck. Although more reports on the usefulness and of safety dual-stenting techniques are required, [33][34][35] those methods may be useful because they can be performed using common neck bridging stents.…”

Section: Double-catheter Techniquementioning

confidence: 99%

Endovascular Treatments for Aneurysms Involving a Major Branch

Orito,

Hirohata,

Abe

et al. 2024

JNET

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Remarkable advances have been made in the endovascular treatment of intracranial cerebral aneurysms. These advances include various adjunctive techniques, increased indications for endovascular treatment, and improved treatment results. Furthermore, the number of cerebral aneurysm treatments using flow diverters (FDs) is expected to increase. However, the reported long-term rate of branch artery occlusion after FD treatment has been reported is 15.8%. Moreover, the complete aneurysm obliteration rate is low if normal branches arise from an aneurysm neck or dome. Flow diverter placement for ophthalmic artery, posterior communicating artery, and anterior choroidal artery aneurysms is often difficult because these normal branches often arise from the aneurysm neck or dome. Therefore, in many cases, coil embolization, which can occlude the aneurysm while preserving branch vessels, should be selected. Although not yet established, various adjunctive techniques and other endovascular treatments that can be performed safely have been reported. Treatment must be planned after understanding the advantages and disadvantages of each treatment method.

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Usefulness and problems of Y-Stent and T-Stent assisted coiling for unruptured cerebral aneurysms

Cited by 2 publications

References 10 publications

A systematic review and meta-analysis of Comaneci/Cascade temporary neck bridging devices for the treatment of intracranial aneurysms

A systematic review and meta-analysis of Comaneci/Cascade temporary neck bridging devices for the treatment of intracranial aneurysms

Endovascular Treatments for Aneurysms Involving a Major Branch

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