Various techniques of stent-assisted coil embolization of wide-necked or fusiform artherosclerotic and dissecting unruptured vertebrobasilar artery aneurysms for reducing recanalization: mid-term results
Background Coil embolization of wide-necked or fusiform vertebrobasilar aneurysms is challenging and tends to involve frequent recanalization. Purpose The aim of our study was to evaluate complications and mid-term outcomes of complex vertebrobasilar artery aneurysms after stent-assisted coiling wit...
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| Veröffentlicht in: | Acta neurochirurgica 2013-11, Vol.155 (11), p.2009-2017 |
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| creator | Rho, Myung Ho Park, Hee Jin Chung, Eun Chul Choi, Yoon Jung Lee, So Yeon Won, Yu Sam Kim, Byung Moon |
| description | Background
Coil embolization of wide-necked or fusiform vertebrobasilar aneurysms is challenging and tends to involve frequent recanalization.
Purpose
The aim of our study was to evaluate complications and mid-term outcomes of complex vertebrobasilar artery aneurysms after stent-assisted coiling with various techniques.
Methods
We retrospectively evaluated 28 cases of unruptured vertebrobasilar aneurysm treated by stent-assisted coiling.
Results
Forty-four of the 45 stents placed in 28 patients were deployed at the desired location (97.8 %). Single stent-assisted coiling was performed in 14 aneurysms, a stent-within-a-stent (SWS) technique was used in 12 aneurysms, and Y-stent-assisted coiling was employed in four basilar tip aneurysms. Two basilar tip aneurysms treated by single stent-assisted coiling recurred and were retreated by SWS and Y-stent-assisted coiling. Complete embolization was achieved in 19 aneurysms (67.8 %), and remnant neck persisted in eight aneurysms (28.6 %) and remnant aneurysm was noted in one aneurysm (3.6 %). Permanent neurologic deficit (Modified Rankin Scale 1 and 4) was noted in two patients (7.1 %). Angiographic follow-up (mean follow-up period: 20.8 months) was performed in 20 patients. Major recanalization occurred in two basilar tip aneurysms (10 %) and minor compaction was noted in one superior cerebellar artery aneurysm. The remaining 17 aneurysms were stable or improved (85 %).
Conclusions
Complex vertebrobasilar aneurysm embolization with stent-assisted techniques was effective and feasible as a method for reducing recanalization during midterm angiographic follow-up. Large and wide-necked basilar tip aneurysms showed frequent major recanalization, and compact packing with single or Y-stent-assisted coiling is needed to prevent recanalization even if coiling will be done without stenting. |
| doi_str_mv | 10.1007/s00701-013-1866-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1458541071</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1443995468</sourcerecordid><originalsourceid>FETCH-LOGICAL-c471t-a5054687cf2b7ca9b4b9b01da88c66844e9668af704a5c0eaca807e506337ad3</originalsourceid><addsrcrecordid>eNqNksFu1TAQRSMEoqXwAWyQJTZsQu3EsR12qKIFqVI3VbeR40xalyR-eOyi8Iv8FBNeixASUjdjR3PuzXh0i-K14O8F5_oYqXBRclGXwihVrk-KQ97KqqTCn9KdU1dVyhwULxBv6avSsn5eHFSSG6GNOix-XtnoQ0aWwN0s_lsGZGFkmGBJpUX0dBuYC35iMPdh8j9s8mHZmO9-gHIB95WAENmY0Y8hzszGdAMxoJuoJu-YXQY2eERwyS_XLC8x71KOJLuDmKCPobfoJxs3KcSVBJDjijMyMmQEZrcJIzi72IcRPrDZDyXxMzUwTwlfFs9GOyG8uj-PisvTT5cnn8vzi7MvJx_PSye1oFc1vJHKaDdWvXa27WXf9lwM1hinlJESWjrsqLm0jeNgnTVcQ8NVXWs71EfFu73tLoZtX6mbPTqYJhqbNtkJ2ZhGCq7FI1BZt-02DaFv_0FvQ4703N9U1VaqVZuh2FOOFowRxm4X_Wzj2gnebZno9pnoKBPdloluJc2be-fczzD8UTyEgIBqDyC1lmuIf_36v66_AOfAyNQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1442926961</pqid></control><display><type>article</type><title>Various techniques of stent-assisted coil embolization of wide-necked or fusiform artherosclerotic and dissecting unruptured vertebrobasilar artery aneurysms for reducing recanalization: mid-term results</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Rho, Myung Ho ; Park, Hee Jin ; Chung, Eun Chul ; Choi, Yoon Jung ; Lee, So Yeon ; Won, Yu Sam ; Kim, Byung Moon</creator><creatorcontrib>Rho, Myung Ho ; Park, Hee Jin ; Chung, Eun Chul ; Choi, Yoon Jung ; Lee, So Yeon ; Won, Yu Sam ; Kim, Byung Moon</creatorcontrib><description>Background
Coil embolization of wide-necked or fusiform vertebrobasilar aneurysms is challenging and tends to involve frequent recanalization.
Purpose
The aim of our study was to evaluate complications and mid-term outcomes of complex vertebrobasilar artery aneurysms after stent-assisted coiling with various techniques.
Methods
We retrospectively evaluated 28 cases of unruptured vertebrobasilar aneurysm treated by stent-assisted coiling.
Results
Forty-four of the 45 stents placed in 28 patients were deployed at the desired location (97.8 %). Single stent-assisted coiling was performed in 14 aneurysms, a stent-within-a-stent (SWS) technique was used in 12 aneurysms, and Y-stent-assisted coiling was employed in four basilar tip aneurysms. Two basilar tip aneurysms treated by single stent-assisted coiling recurred and were retreated by SWS and Y-stent-assisted coiling. Complete embolization was achieved in 19 aneurysms (67.8 %), and remnant neck persisted in eight aneurysms (28.6 %) and remnant aneurysm was noted in one aneurysm (3.6 %). Permanent neurologic deficit (Modified Rankin Scale 1 and 4) was noted in two patients (7.1 %). Angiographic follow-up (mean follow-up period: 20.8 months) was performed in 20 patients. Major recanalization occurred in two basilar tip aneurysms (10 %) and minor compaction was noted in one superior cerebellar artery aneurysm. The remaining 17 aneurysms were stable or improved (85 %).
Conclusions
Complex vertebrobasilar aneurysm embolization with stent-assisted techniques was effective and feasible as a method for reducing recanalization during midterm angiographic follow-up. Large and wide-necked basilar tip aneurysms showed frequent major recanalization, and compact packing with single or Y-stent-assisted coiling is needed to prevent recanalization even if coiling will be done without stenting.</description><identifier>ISSN: 0001-6268</identifier><identifier>EISSN: 0942-0940</identifier><identifier>DOI: 10.1007/s00701-013-1866-y</identifier><identifier>PMID: 24081786</identifier><language>eng</language><publisher>Vienna: Springer Vienna</publisher><subject>Adult ; Aged ; Aneurysm, Dissecting - complications ; Aneurysm, Dissecting - therapy ; Basilar Artery - surgery ; Cerebral Angiography - methods ; Clinical Article - Vascular ; Embolization, Therapeutic - instrumentation ; Embolization, Therapeutic - methods ; Humans ; Interventional Radiology ; Intracranial Aneurysm - complications ; Intracranial Aneurysm - therapy ; Medicine ; Medicine & Public Health ; Middle Aged ; Minimally Invasive Surgery ; Neurology ; Neuroradiology ; Neurosurgery ; Retrospective Studies ; Secondary Prevention ; Stents ; Surgical Orthopedics ; Treatment Outcome</subject><ispartof>Acta neurochirurgica, 2013-11, Vol.155 (11), p.2009-2017</ispartof><rights>Springer-Verlag Wien 2013</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c471t-a5054687cf2b7ca9b4b9b01da88c66844e9668af704a5c0eaca807e506337ad3</citedby><cites>FETCH-LOGICAL-c471t-a5054687cf2b7ca9b4b9b01da88c66844e9668af704a5c0eaca807e506337ad3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00701-013-1866-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00701-013-1866-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24081786$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rho, Myung Ho</creatorcontrib><creatorcontrib>Park, Hee Jin</creatorcontrib><creatorcontrib>Chung, Eun Chul</creatorcontrib><creatorcontrib>Choi, Yoon Jung</creatorcontrib><creatorcontrib>Lee, So Yeon</creatorcontrib><creatorcontrib>Won, Yu Sam</creatorcontrib><creatorcontrib>Kim, Byung Moon</creatorcontrib><title>Various techniques of stent-assisted coil embolization of wide-necked or fusiform artherosclerotic and dissecting unruptured vertebrobasilar artery aneurysms for reducing recanalization: mid-term results</title><title>Acta neurochirurgica</title><addtitle>Acta Neurochir</addtitle><addtitle>Acta Neurochir (Wien)</addtitle><description>Background
Coil embolization of wide-necked or fusiform vertebrobasilar aneurysms is challenging and tends to involve frequent recanalization.
Purpose
The aim of our study was to evaluate complications and mid-term outcomes of complex vertebrobasilar artery aneurysms after stent-assisted coiling with various techniques.
Methods
We retrospectively evaluated 28 cases of unruptured vertebrobasilar aneurysm treated by stent-assisted coiling.
Results
Forty-four of the 45 stents placed in 28 patients were deployed at the desired location (97.8 %). Single stent-assisted coiling was performed in 14 aneurysms, a stent-within-a-stent (SWS) technique was used in 12 aneurysms, and Y-stent-assisted coiling was employed in four basilar tip aneurysms. Two basilar tip aneurysms treated by single stent-assisted coiling recurred and were retreated by SWS and Y-stent-assisted coiling. Complete embolization was achieved in 19 aneurysms (67.8 %), and remnant neck persisted in eight aneurysms (28.6 %) and remnant aneurysm was noted in one aneurysm (3.6 %). Permanent neurologic deficit (Modified Rankin Scale 1 and 4) was noted in two patients (7.1 %). Angiographic follow-up (mean follow-up period: 20.8 months) was performed in 20 patients. Major recanalization occurred in two basilar tip aneurysms (10 %) and minor compaction was noted in one superior cerebellar artery aneurysm. The remaining 17 aneurysms were stable or improved (85 %).
Conclusions
Complex vertebrobasilar aneurysm embolization with stent-assisted techniques was effective and feasible as a method for reducing recanalization during midterm angiographic follow-up. Large and wide-necked basilar tip aneurysms showed frequent major recanalization, and compact packing with single or Y-stent-assisted coiling is needed to prevent recanalization even if coiling will be done without stenting.</description><subject>Adult</subject><subject>Aged</subject><subject>Aneurysm, Dissecting - complications</subject><subject>Aneurysm, Dissecting - therapy</subject><subject>Basilar Artery - surgery</subject><subject>Cerebral Angiography - methods</subject><subject>Clinical Article - Vascular</subject><subject>Embolization, Therapeutic - instrumentation</subject><subject>Embolization, Therapeutic - methods</subject><subject>Humans</subject><subject>Interventional Radiology</subject><subject>Intracranial Aneurysm - complications</subject><subject>Intracranial Aneurysm - therapy</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Minimally Invasive Surgery</subject><subject>Neurology</subject><subject>Neuroradiology</subject><subject>Neurosurgery</subject><subject>Retrospective Studies</subject><subject>Secondary Prevention</subject><subject>Stents</subject><subject>Surgical Orthopedics</subject><subject>Treatment Outcome</subject><issn>0001-6268</issn><issn>0942-0940</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNksFu1TAQRSMEoqXwAWyQJTZsQu3EsR12qKIFqVI3VbeR40xalyR-eOyi8Iv8FBNeixASUjdjR3PuzXh0i-K14O8F5_oYqXBRclGXwihVrk-KQ97KqqTCn9KdU1dVyhwULxBv6avSsn5eHFSSG6GNOix-XtnoQ0aWwN0s_lsGZGFkmGBJpUX0dBuYC35iMPdh8j9s8mHZmO9-gHIB95WAENmY0Y8hzszGdAMxoJuoJu-YXQY2eERwyS_XLC8x71KOJLuDmKCPobfoJxs3KcSVBJDjijMyMmQEZrcJIzi72IcRPrDZDyXxMzUwTwlfFs9GOyG8uj-PisvTT5cnn8vzi7MvJx_PSye1oFc1vJHKaDdWvXa27WXf9lwM1hinlJESWjrsqLm0jeNgnTVcQ8NVXWs71EfFu73tLoZtX6mbPTqYJhqbNtkJ2ZhGCq7FI1BZt-02DaFv_0FvQ4703N9U1VaqVZuh2FOOFowRxm4X_Wzj2gnebZno9pnoKBPdloluJc2be-fczzD8UTyEgIBqDyC1lmuIf_36v66_AOfAyNQ</recordid><startdate>20131101</startdate><enddate>20131101</enddate><creator>Rho, Myung Ho</creator><creator>Park, Hee Jin</creator><creator>Chung, Eun Chul</creator><creator>Choi, Yoon Jung</creator><creator>Lee, So Yeon</creator><creator>Won, Yu Sam</creator><creator>Kim, Byung Moon</creator><general>Springer Vienna</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20131101</creationdate><title>Various techniques of stent-assisted coil embolization of wide-necked or fusiform artherosclerotic and dissecting unruptured vertebrobasilar artery aneurysms for reducing recanalization: mid-term results</title><author>Rho, Myung Ho ; Park, Hee Jin ; Chung, Eun Chul ; Choi, Yoon Jung ; Lee, So Yeon ; Won, Yu Sam ; Kim, Byung Moon</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c471t-a5054687cf2b7ca9b4b9b01da88c66844e9668af704a5c0eaca807e506337ad3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aneurysm, Dissecting - complications</topic><topic>Aneurysm, Dissecting - therapy</topic><topic>Basilar Artery - surgery</topic><topic>Cerebral Angiography - methods</topic><topic>Clinical Article - Vascular</topic><topic>Embolization, Therapeutic - instrumentation</topic><topic>Embolization, Therapeutic - methods</topic><topic>Humans</topic><topic>Interventional Radiology</topic><topic>Intracranial Aneurysm - complications</topic><topic>Intracranial Aneurysm - therapy</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Minimally Invasive Surgery</topic><topic>Neurology</topic><topic>Neuroradiology</topic><topic>Neurosurgery</topic><topic>Retrospective Studies</topic><topic>Secondary Prevention</topic><topic>Stents</topic><topic>Surgical Orthopedics</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rho, Myung Ho</creatorcontrib><creatorcontrib>Park, Hee Jin</creatorcontrib><creatorcontrib>Chung, Eun Chul</creatorcontrib><creatorcontrib>Choi, Yoon Jung</creatorcontrib><creatorcontrib>Lee, So Yeon</creatorcontrib><creatorcontrib>Won, Yu Sam</creatorcontrib><creatorcontrib>Kim, Byung Moon</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Acta neurochirurgica</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rho, Myung Ho</au><au>Park, Hee Jin</au><au>Chung, Eun Chul</au><au>Choi, Yoon Jung</au><au>Lee, So Yeon</au><au>Won, Yu Sam</au><au>Kim, Byung Moon</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Various techniques of stent-assisted coil embolization of wide-necked or fusiform artherosclerotic and dissecting unruptured vertebrobasilar artery aneurysms for reducing recanalization: mid-term results</atitle><jtitle>Acta neurochirurgica</jtitle><stitle>Acta Neurochir</stitle><addtitle>Acta Neurochir (Wien)</addtitle><date>2013-11-01</date><risdate>2013</risdate><volume>155</volume><issue>11</issue><spage>2009</spage><epage>2017</epage><pages>2009-2017</pages><issn>0001-6268</issn><eissn>0942-0940</eissn><abstract>Background
Coil embolization of wide-necked or fusiform vertebrobasilar aneurysms is challenging and tends to involve frequent recanalization.
Purpose
The aim of our study was to evaluate complications and mid-term outcomes of complex vertebrobasilar artery aneurysms after stent-assisted coiling with various techniques.
Methods
We retrospectively evaluated 28 cases of unruptured vertebrobasilar aneurysm treated by stent-assisted coiling.
Results
Forty-four of the 45 stents placed in 28 patients were deployed at the desired location (97.8 %). Single stent-assisted coiling was performed in 14 aneurysms, a stent-within-a-stent (SWS) technique was used in 12 aneurysms, and Y-stent-assisted coiling was employed in four basilar tip aneurysms. Two basilar tip aneurysms treated by single stent-assisted coiling recurred and were retreated by SWS and Y-stent-assisted coiling. Complete embolization was achieved in 19 aneurysms (67.8 %), and remnant neck persisted in eight aneurysms (28.6 %) and remnant aneurysm was noted in one aneurysm (3.6 %). Permanent neurologic deficit (Modified Rankin Scale 1 and 4) was noted in two patients (7.1 %). Angiographic follow-up (mean follow-up period: 20.8 months) was performed in 20 patients. Major recanalization occurred in two basilar tip aneurysms (10 %) and minor compaction was noted in one superior cerebellar artery aneurysm. The remaining 17 aneurysms were stable or improved (85 %).
Conclusions
Complex vertebrobasilar aneurysm embolization with stent-assisted techniques was effective and feasible as a method for reducing recanalization during midterm angiographic follow-up. Large and wide-necked basilar tip aneurysms showed frequent major recanalization, and compact packing with single or Y-stent-assisted coiling is needed to prevent recanalization even if coiling will be done without stenting.</abstract><cop>Vienna</cop><pub>Springer Vienna</pub><pmid>24081786</pmid><doi>10.1007/s00701-013-1866-y</doi><tpages>9</tpages></addata></record> |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Adult Aged Aneurysm, Dissecting - complications Aneurysm, Dissecting - therapy Basilar Artery - surgery Cerebral Angiography - methods Clinical Article - Vascular Embolization, Therapeutic - instrumentation Embolization, Therapeutic - methods Humans Interventional Radiology Intracranial Aneurysm - complications Intracranial Aneurysm - therapy Medicine Medicine & Public Health Middle Aged Minimally Invasive Surgery Neurology Neuroradiology Neurosurgery Retrospective Studies Secondary Prevention Stents Surgical Orthopedics Treatment Outcome |
| title | Various techniques of stent-assisted coil embolization of wide-necked or fusiform artherosclerotic and dissecting unruptured vertebrobasilar artery aneurysms for reducing recanalization: mid-term results |
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