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Research ArticleNeurointervention

“Y” and “X” Stent-Assisted Coiling of Complex and Wide-Neck Intracranial Bifurcation Aneurysms

B. Bartolini, R. Blanc, S. Pistocchi, H. Redjem and M. Piotin
American Journal of Neuroradiology November 2014, 35 (11) 2153-2158; DOI: https://doi.org/10.3174/ajnr.A4060
B. Bartolini
aFrom the Department of Interventional and Functional Neuroradiology, Foundation Rothschild Hospital, Paris, France.
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R. Blanc
aFrom the Department of Interventional and Functional Neuroradiology, Foundation Rothschild Hospital, Paris, France.
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S. Pistocchi
aFrom the Department of Interventional and Functional Neuroradiology, Foundation Rothschild Hospital, Paris, France.
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H. Redjem
aFrom the Department of Interventional and Functional Neuroradiology, Foundation Rothschild Hospital, Paris, France.
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M. Piotin
aFrom the Department of Interventional and Functional Neuroradiology, Foundation Rothschild Hospital, Paris, France.
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Article Figures & Data

Tables

    • View popup
    Table 1:

    Summary of demographics and clinical data

    DemographicsNo.%
    Sex
        Male3536.1
        Female6263.9
    Aneurysm location
        MCA5754.2
        AcomA3028.6
        Basilar tip1716.2
        Carotid termination11.0
    Clinical finding
        Incidental discovery7975.2
        Recurrence2019.0
        SAH54.8
        Compression11.0
    Aneurysm size
        Small: 0–10 mm9085.7
        Large: 10–25 mm1312.4
        Giant: >25 mm21.9
    • View popup
    Table 2:

    Summary of aneurysm characteristics

    Aneurysm Size (No.) (%)Mean ± σ (mm)Ruptured (No.) (%)Complex (No.) (%)
    Small: 90 (85.7)5 (5.5)27 (30.0)
        Largest diameter6.5 ± 2.1
        Neck5.0 ± 1.3
        Dome/neck1.1 ± 0.3
    Large: 13 (12.4)0 (0)7 (54.0)
        Largest diameter12.7 ± 2.6
        Neck6.8 ± 2.0
        Dome/neck1.6 ± 0.7
    Giant: 2 (1.9)0 (0)0 (0)
        Largest diameter28.3 ± 3.9
        Neck5.5 ± 1.1
        Dome/neck2.3 ± 1.7
    • View popup
    Table 3:

    Summary of stent types and configurations in successful treatments

    YX
    Neuroforma + Neuroform473
    Neuroform + Enterpriseb272
    Enterprise + Enterprise41
    Neuroform + Solitaire ABc2–
    LVISd + LVIS1–
    LVIS Jrd + LVIS Jr3–
    Neuroform + Baby LEOe1–
    • ↵a Stryker Neurovascular, Fremont, California.

    • ↵b Cordis Neurovascular, Miami, Florida.

    • ↵c Covidien, Irvine, California.

    • ↵d MicroVention, Tustin, California.

    • ↵e Balt Extrusion, Montmorency, France.

    • View popup
    Table 4:

    Summary of attempted stenting

    Age (yr), SexAneurysm LocationAneurysms Treated during the ProcedureStentsEventFinal ResultF/UmRS Score
    50, FMCA10Sac perforation with the guidewireC–0
    62, FMCA10Sac perforation with the microdelivery stent system and exchange guidewireA–4
    70, FMCA21First stent was delivered too distally, with the proximal end covering the neck; impossible to navigate the microcatheter in the second branchC, CB, B0
    38, MAcomA11Guidewire tip broke in the parent vessel and a single stent was delivered due to the impossibility of navigating the microcatheter in the second branchCA0
    48, FMCA12First stent was delivered too distally, no overlappingCC0
    30, FAcomA12First stent was delivered too distally, no overlappingBA0
    86, FBA12First stent fell into aneurysmal sac, no overlappingCC2
    51, FCT12First stent fell into aneurysmal sac, no overlappingC–0
    58, FAcomA22Second stent was deployed inside the first one (coaxial)C, CC, C0
    • Note:—F/U indicates follow-up; BA, basilar artery; CT, carotid termination; A, complete occlusion; B, neck remnant; C, sac remnant.

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American Journal of Neuroradiology: 35 (11)
American Journal of Neuroradiology
Vol. 35, Issue 11
1 Nov 2014
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Cite this article
B. Bartolini, R. Blanc, S. Pistocchi, H. Redjem, M. Piotin
“Y” and “X” Stent-Assisted Coiling of Complex and Wide-Neck Intracranial Bifurcation Aneurysms
American Journal of Neuroradiology Nov 2014, 35 (11) 2153-2158; DOI: 10.3174/ajnr.A4060

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“Y” and “X” Stent-Assisted Coiling of Complex and Wide-Neck Intracranial Bifurcation Aneurysms
B. Bartolini, R. Blanc, S. Pistocchi, H. Redjem, M. Piotin
American Journal of Neuroradiology Nov 2014, 35 (11) 2153-2158; DOI: 10.3174/ajnr.A4060
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  • Y-Stent-Assisted Coiling of Wide-Neck Bifurcation Intracranial Aneurysms: A Meta-Analysis
  • Initial and Long-Term Outcomes of Complex Bifurcation Aneurysms Treated by Y-Stent-Assisted Coiling with Low-Profile Braided Stents
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  • WEB Treatment of Ruptured Intracranial Aneurysms
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  • Flow-Diverter Stents for the Treatment of Saccular Middle Cerebral Artery Bifurcation Aneurysms
  • Y-stent assisted coiling of bifurcation aneurysms with Enterprise stent: long-term follow-up
  • PulseRider Stent-Assisted Coiling of Wide-Neck Bifurcation Aneurysms: Periprocedural Results in an International Series
  • One-Year Angiographic Follow-Up after WEB-SL Endovascular Treatment of Wide-Neck Bifurcation Intracranial Aneurysms
  • pCONus Device for the Endovascular Treatment of Wide-Neck Middle Cerebral Artery Aneurysms
  • Endovascular Treatment of Wide-Neck Anterior Communicating Artery Aneurysms Using WEB-DL and WEB-SL: Short-Term Results in a Multicenter Study
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