Waffle-cone technique with Solitaire™ AB Remodeling Device: endovascular treatment of highly selected complex cerebral aneurysms
Introduction To evaluate patients with complex aneurysms who underwent waffle-cone stent-assisted coil embolization. Methods From February 2008 to February 2010, consecutive data were collected from 80 patients with aneurysms treated with the Solitaire™ AB Remodeling Device followed by a standard co...
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| Veröffentlicht in: | Neuroradiology 2011-12, Vol.53 (12), p.961-972 |
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| creator | Sychra, Vojtech Klisch, Joachim Werner, Maren Dettenborn, Christian Petrovitch, Alexander Strasilla, Christoph Gerlach, Rüdiger Rosahl, Steffen Holtmannspötter, Markus |
| description | Introduction
To evaluate patients with complex aneurysms who underwent waffle-cone stent-assisted coil embolization.
Methods
From February 2008 to February 2010, consecutive data were collected from 80 patients with aneurysms treated with the Solitaire™ AB Remodeling Device followed by a standard coiling procedure using bare or/and bioactive coils. Six of these patients were treated using the “waffle-cone-technique” placing the distal end of a stent directly into the base of a bifurcation aneurysm and coiling through the expanded and cone-shaped distal end of the stent allowing for preservation of parent artery patency. The aneurysms were located at the P3 segment of the posterior cerebral artery (
n
= 1), the middle cerebral artery bifurcation (
n
= 1), the basilar tip (
n
= 2), and the AComAnt (
n
= 2). Four patients underwent follow-up (2–7 months, mean 4.5 months).
Results
Waffle-cone positioning of the Solitaire™ AB Remodeling Device was obtained in all cases without technical problems. No permanent procedural morbidity was observed. In all patients, a Raymond class 2 occlusion was obtained and five patients left the hospital with a good clinical status (mRS0
n
= 3, mRS1
n
= 1) or no new neurologic deficits (mRS4
n
= 1). One patient with SAH III died due to severe vasospasms. Due to major recanalization during follow-up, retreatment was necessary or is planned in four cases; one asymptomatic intimal hyperplasia was observed 8 weeks after initial treatment.
Conclusion
The waffle-cone technique may enhance the possibilities of the endovascular treatment of these complex aneurysms. Due to the high rate of recanalization requiring endovascular retreatment, stringent angiographic and clinical follow-up is warranted. |
| doi_str_mv | 10.1007/s00234-010-0766-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_926883321</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>904010043</sourcerecordid><originalsourceid>FETCH-LOGICAL-c432t-e76d47f56188a93899cad854368f37916121eee9de58963f28d5fb2ae51dbef73</originalsourceid><addsrcrecordid>eNqFkc2KFDEUhYMoTjv6AG4kCOKqND9VScrdOOMfDAj-4LJIJzfdGVKVNkmN01vxSXw0n8S03TogiKss7ndP7jkHofuUPKGEyKeZEMbbhlDSEClEI26gBW05a2jPyE20qGPV8L4lR-hOzheEEC65vI2OGFGMctou0NdP2rkAjYkT4AJmPfnPM-Avvqzx-xh80T7Bj2_f8clz_A7GaCH4aYXP4NIbeIZhsvFSZzMHnXBJoMsIU8HR4bVfrcMWZwhgClhs4rgJcIUNJFgmHbCeYE7bPOa76JbTIcO9w3uMPr588eH0dXP-9tWb05PzxlRLpQEpbCtdJ6hSuueq7422qmu5UI7LngrKKAD0FjrVC-6Ysp1bMg0dtUtwkh-jx3vdTYrVYy7D6LOBEOolcc5Dz4RSnNdg_kuStmZOWl7Jh3-RF3FOU7VRIU4lp7_k6B4yKeacwA2b5EedtgMlw67IYV_kUEWHXZGDqDsPDsLzcgT7Z-N3cxV4dABq_Dq4pCfj8zXXMVm97ITYnst1NK0gXV_4799_AnFItxU</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>903173121</pqid></control><display><type>article</type><title>Waffle-cone technique with Solitaire™ AB Remodeling Device: endovascular treatment of highly selected complex cerebral aneurysms</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Sychra, Vojtech ; Klisch, Joachim ; Werner, Maren ; Dettenborn, Christian ; Petrovitch, Alexander ; Strasilla, Christoph ; Gerlach, Rüdiger ; Rosahl, Steffen ; Holtmannspötter, Markus</creator><creatorcontrib>Sychra, Vojtech ; Klisch, Joachim ; Werner, Maren ; Dettenborn, Christian ; Petrovitch, Alexander ; Strasilla, Christoph ; Gerlach, Rüdiger ; Rosahl, Steffen ; Holtmannspötter, Markus</creatorcontrib><description>Introduction
To evaluate patients with complex aneurysms who underwent waffle-cone stent-assisted coil embolization.
Methods
From February 2008 to February 2010, consecutive data were collected from 80 patients with aneurysms treated with the Solitaire™ AB Remodeling Device followed by a standard coiling procedure using bare or/and bioactive coils. Six of these patients were treated using the “waffle-cone-technique” placing the distal end of a stent directly into the base of a bifurcation aneurysm and coiling through the expanded and cone-shaped distal end of the stent allowing for preservation of parent artery patency. The aneurysms were located at the P3 segment of the posterior cerebral artery (
n
= 1), the middle cerebral artery bifurcation (
n
= 1), the basilar tip (
n
= 2), and the AComAnt (
n
= 2). Four patients underwent follow-up (2–7 months, mean 4.5 months).
Results
Waffle-cone positioning of the Solitaire™ AB Remodeling Device was obtained in all cases without technical problems. No permanent procedural morbidity was observed. In all patients, a Raymond class 2 occlusion was obtained and five patients left the hospital with a good clinical status (mRS0
n
= 3, mRS1
n
= 1) or no new neurologic deficits (mRS4
n
= 1). One patient with SAH III died due to severe vasospasms. Due to major recanalization during follow-up, retreatment was necessary or is planned in four cases; one asymptomatic intimal hyperplasia was observed 8 weeks after initial treatment.
Conclusion
The waffle-cone technique may enhance the possibilities of the endovascular treatment of these complex aneurysms. Due to the high rate of recanalization requiring endovascular retreatment, stringent angiographic and clinical follow-up is warranted.</description><identifier>ISSN: 0028-3940</identifier><identifier>EISSN: 1432-1920</identifier><identifier>DOI: 10.1007/s00234-010-0766-6</identifier><identifier>PMID: 20821314</identifier><identifier>CODEN: NRDYAB</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Adult ; Adult and adolescent clinical studies ; Aged ; Aneurysm ; Aneurysms ; Antibodies ; Biological and medical sciences ; Cardiovascular system ; Cerebral blood flow ; Coiling ; Data processing ; Embolization ; Endovascular Procedures - instrumentation ; Endovascular Procedures - methods ; Female ; Hospitals ; Humans ; Hyperplasia ; Imaging ; Implants ; Interventional Neuroradiology ; Intracranial Aneurysm - diagnostic imaging ; Intracranial Aneurysm - surgery ; Investigative techniques, diagnostic techniques (general aspects) ; Ischemia ; Male ; Medical sciences ; Medicine ; Medicine & Public Health ; Middle Aged ; Miscellaneous ; Mood disorders ; Morbidity ; Nervous system ; Neuroimaging ; Neurology ; Neuroradiology ; Neurosciences ; Neurosurgery ; Preservation ; Prosthesis Design ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Radiodiagnosis. Nmr imagery. Nmr spectrometry ; Radiography, Interventional - methods ; Radiology ; Surgical techniques ; Treatment Outcome ; Vascular surgery ; Vasoconstriction</subject><ispartof>Neuroradiology, 2011-12, Vol.53 (12), p.961-972</ispartof><rights>Springer-Verlag 2010</rights><rights>2015 INIST-CNRS</rights><rights>Springer-Verlag 2011</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c432t-e76d47f56188a93899cad854368f37916121eee9de58963f28d5fb2ae51dbef73</citedby><cites>FETCH-LOGICAL-c432t-e76d47f56188a93899cad854368f37916121eee9de58963f28d5fb2ae51dbef73</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/s00234-010-0766-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00234-010-0766-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25273326$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20821314$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sychra, Vojtech</creatorcontrib><creatorcontrib>Klisch, Joachim</creatorcontrib><creatorcontrib>Werner, Maren</creatorcontrib><creatorcontrib>Dettenborn, Christian</creatorcontrib><creatorcontrib>Petrovitch, Alexander</creatorcontrib><creatorcontrib>Strasilla, Christoph</creatorcontrib><creatorcontrib>Gerlach, Rüdiger</creatorcontrib><creatorcontrib>Rosahl, Steffen</creatorcontrib><creatorcontrib>Holtmannspötter, Markus</creatorcontrib><title>Waffle-cone technique with Solitaire™ AB Remodeling Device: endovascular treatment of highly selected complex cerebral aneurysms</title><title>Neuroradiology</title><addtitle>Neuroradiology</addtitle><addtitle>Neuroradiology</addtitle><description>Introduction
To evaluate patients with complex aneurysms who underwent waffle-cone stent-assisted coil embolization.
Methods
From February 2008 to February 2010, consecutive data were collected from 80 patients with aneurysms treated with the Solitaire™ AB Remodeling Device followed by a standard coiling procedure using bare or/and bioactive coils. Six of these patients were treated using the “waffle-cone-technique” placing the distal end of a stent directly into the base of a bifurcation aneurysm and coiling through the expanded and cone-shaped distal end of the stent allowing for preservation of parent artery patency. The aneurysms were located at the P3 segment of the posterior cerebral artery (
n
= 1), the middle cerebral artery bifurcation (
n
= 1), the basilar tip (
n
= 2), and the AComAnt (
n
= 2). Four patients underwent follow-up (2–7 months, mean 4.5 months).
Results
Waffle-cone positioning of the Solitaire™ AB Remodeling Device was obtained in all cases without technical problems. No permanent procedural morbidity was observed. In all patients, a Raymond class 2 occlusion was obtained and five patients left the hospital with a good clinical status (mRS0
n
= 3, mRS1
n
= 1) or no new neurologic deficits (mRS4
n
= 1). One patient with SAH III died due to severe vasospasms. Due to major recanalization during follow-up, retreatment was necessary or is planned in four cases; one asymptomatic intimal hyperplasia was observed 8 weeks after initial treatment.
Conclusion
The waffle-cone technique may enhance the possibilities of the endovascular treatment of these complex aneurysms. Due to the high rate of recanalization requiring endovascular retreatment, stringent angiographic and clinical follow-up is warranted.</description><subject>Adult</subject><subject>Adult and adolescent clinical studies</subject><subject>Aged</subject><subject>Aneurysm</subject><subject>Aneurysms</subject><subject>Antibodies</subject><subject>Biological and medical sciences</subject><subject>Cardiovascular system</subject><subject>Cerebral blood flow</subject><subject>Coiling</subject><subject>Data processing</subject><subject>Embolization</subject><subject>Endovascular Procedures - instrumentation</subject><subject>Endovascular Procedures - methods</subject><subject>Female</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hyperplasia</subject><subject>Imaging</subject><subject>Implants</subject><subject>Interventional Neuroradiology</subject><subject>Intracranial Aneurysm - diagnostic imaging</subject><subject>Intracranial Aneurysm - surgery</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Ischemia</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Mood disorders</subject><subject>Morbidity</subject><subject>Nervous system</subject><subject>Neuroimaging</subject><subject>Neurology</subject><subject>Neuroradiology</subject><subject>Neurosciences</subject><subject>Neurosurgery</subject><subject>Preservation</subject><subject>Prosthesis Design</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>Radiodiagnosis. Nmr imagery. Nmr spectrometry</subject><subject>Radiography, Interventional - methods</subject><subject>Radiology</subject><subject>Surgical techniques</subject><subject>Treatment Outcome</subject><subject>Vascular surgery</subject><subject>Vasoconstriction</subject><issn>0028-3940</issn><issn>1432-1920</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkc2KFDEUhYMoTjv6AG4kCOKqND9VScrdOOMfDAj-4LJIJzfdGVKVNkmN01vxSXw0n8S03TogiKss7ndP7jkHofuUPKGEyKeZEMbbhlDSEClEI26gBW05a2jPyE20qGPV8L4lR-hOzheEEC65vI2OGFGMctou0NdP2rkAjYkT4AJmPfnPM-Avvqzx-xh80T7Bj2_f8clz_A7GaCH4aYXP4NIbeIZhsvFSZzMHnXBJoMsIU8HR4bVfrcMWZwhgClhs4rgJcIUNJFgmHbCeYE7bPOa76JbTIcO9w3uMPr588eH0dXP-9tWb05PzxlRLpQEpbCtdJ6hSuueq7422qmu5UI7LngrKKAD0FjrVC-6Ysp1bMg0dtUtwkh-jx3vdTYrVYy7D6LOBEOolcc5Dz4RSnNdg_kuStmZOWl7Jh3-RF3FOU7VRIU4lp7_k6B4yKeacwA2b5EedtgMlw67IYV_kUEWHXZGDqDsPDsLzcgT7Z-N3cxV4dABq_Dq4pCfj8zXXMVm97ITYnst1NK0gXV_4799_AnFItxU</recordid><startdate>20111201</startdate><enddate>20111201</enddate><creator>Sychra, Vojtech</creator><creator>Klisch, Joachim</creator><creator>Werner, Maren</creator><creator>Dettenborn, Christian</creator><creator>Petrovitch, Alexander</creator><creator>Strasilla, Christoph</creator><creator>Gerlach, Rüdiger</creator><creator>Rosahl, Steffen</creator><creator>Holtmannspötter, Markus</creator><general>Springer-Verlag</general><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><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>7QO</scope><scope>7RV</scope><scope>7TK</scope><scope>7U7</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20111201</creationdate><title>Waffle-cone technique with Solitaire™ AB Remodeling Device: endovascular treatment of highly selected complex cerebral aneurysms</title><author>Sychra, Vojtech ; Klisch, Joachim ; Werner, Maren ; Dettenborn, Christian ; Petrovitch, Alexander ; Strasilla, Christoph ; Gerlach, Rüdiger ; Rosahl, Steffen ; Holtmannspötter, Markus</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c432t-e76d47f56188a93899cad854368f37916121eee9de58963f28d5fb2ae51dbef73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult</topic><topic>Adult and adolescent clinical studies</topic><topic>Aged</topic><topic>Aneurysm</topic><topic>Aneurysms</topic><topic>Antibodies</topic><topic>Biological and medical sciences</topic><topic>Cardiovascular system</topic><topic>Cerebral blood flow</topic><topic>Coiling</topic><topic>Data processing</topic><topic>Embolization</topic><topic>Endovascular Procedures - instrumentation</topic><topic>Endovascular Procedures - methods</topic><topic>Female</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Hyperplasia</topic><topic>Imaging</topic><topic>Implants</topic><topic>Interventional Neuroradiology</topic><topic>Intracranial Aneurysm - diagnostic imaging</topic><topic>Intracranial Aneurysm - surgery</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Ischemia</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>Mood disorders</topic><topic>Morbidity</topic><topic>Nervous system</topic><topic>Neuroimaging</topic><topic>Neurology</topic><topic>Neuroradiology</topic><topic>Neurosciences</topic><topic>Neurosurgery</topic><topic>Preservation</topic><topic>Prosthesis Design</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopathology. Psychiatry</topic><topic>Radiodiagnosis. Nmr imagery. Nmr spectrometry</topic><topic>Radiography, Interventional - methods</topic><topic>Radiology</topic><topic>Surgical techniques</topic><topic>Treatment Outcome</topic><topic>Vascular surgery</topic><topic>Vasoconstriction</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sychra, Vojtech</creatorcontrib><creatorcontrib>Klisch, Joachim</creatorcontrib><creatorcontrib>Werner, Maren</creatorcontrib><creatorcontrib>Dettenborn, Christian</creatorcontrib><creatorcontrib>Petrovitch, Alexander</creatorcontrib><creatorcontrib>Strasilla, Christoph</creatorcontrib><creatorcontrib>Gerlach, Rüdiger</creatorcontrib><creatorcontrib>Rosahl, Steffen</creatorcontrib><creatorcontrib>Holtmannspötter, Markus</creatorcontrib><collection>Pascal-Francis</collection><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>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology 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>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection (ProQuest)</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</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>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Neuroradiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sychra, Vojtech</au><au>Klisch, Joachim</au><au>Werner, Maren</au><au>Dettenborn, Christian</au><au>Petrovitch, Alexander</au><au>Strasilla, Christoph</au><au>Gerlach, Rüdiger</au><au>Rosahl, Steffen</au><au>Holtmannspötter, Markus</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Waffle-cone technique with Solitaire™ AB Remodeling Device: endovascular treatment of highly selected complex cerebral aneurysms</atitle><jtitle>Neuroradiology</jtitle><stitle>Neuroradiology</stitle><addtitle>Neuroradiology</addtitle><date>2011-12-01</date><risdate>2011</risdate><volume>53</volume><issue>12</issue><spage>961</spage><epage>972</epage><pages>961-972</pages><issn>0028-3940</issn><eissn>1432-1920</eissn><coden>NRDYAB</coden><abstract>Introduction
To evaluate patients with complex aneurysms who underwent waffle-cone stent-assisted coil embolization.
Methods
From February 2008 to February 2010, consecutive data were collected from 80 patients with aneurysms treated with the Solitaire™ AB Remodeling Device followed by a standard coiling procedure using bare or/and bioactive coils. Six of these patients were treated using the “waffle-cone-technique” placing the distal end of a stent directly into the base of a bifurcation aneurysm and coiling through the expanded and cone-shaped distal end of the stent allowing for preservation of parent artery patency. The aneurysms were located at the P3 segment of the posterior cerebral artery (
n
= 1), the middle cerebral artery bifurcation (
n
= 1), the basilar tip (
n
= 2), and the AComAnt (
n
= 2). Four patients underwent follow-up (2–7 months, mean 4.5 months).
Results
Waffle-cone positioning of the Solitaire™ AB Remodeling Device was obtained in all cases without technical problems. No permanent procedural morbidity was observed. In all patients, a Raymond class 2 occlusion was obtained and five patients left the hospital with a good clinical status (mRS0
n
= 3, mRS1
n
= 1) or no new neurologic deficits (mRS4
n
= 1). One patient with SAH III died due to severe vasospasms. Due to major recanalization during follow-up, retreatment was necessary or is planned in four cases; one asymptomatic intimal hyperplasia was observed 8 weeks after initial treatment.
Conclusion
The waffle-cone technique may enhance the possibilities of the endovascular treatment of these complex aneurysms. Due to the high rate of recanalization requiring endovascular retreatment, stringent angiographic and clinical follow-up is warranted.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>20821314</pmid><doi>10.1007/s00234-010-0766-6</doi><tpages>12</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0028-3940 |
| ispartof | Neuroradiology, 2011-12, Vol.53 (12), p.961-972 |
| issn | 0028-3940 1432-1920 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Adult Adult and adolescent clinical studies Aged Aneurysm Aneurysms Antibodies Biological and medical sciences Cardiovascular system Cerebral blood flow Coiling Data processing Embolization Endovascular Procedures - instrumentation Endovascular Procedures - methods Female Hospitals Humans Hyperplasia Imaging Implants Interventional Neuroradiology Intracranial Aneurysm - diagnostic imaging Intracranial Aneurysm - surgery Investigative techniques, diagnostic techniques (general aspects) Ischemia Male Medical sciences Medicine Medicine & Public Health Middle Aged Miscellaneous Mood disorders Morbidity Nervous system Neuroimaging Neurology Neuroradiology Neurosciences Neurosurgery Preservation Prosthesis Design Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Radiodiagnosis. Nmr imagery. Nmr spectrometry Radiography, Interventional - methods Radiology Surgical techniques Treatment Outcome Vascular surgery Vasoconstriction |
| title | Waffle-cone technique with Solitaire™ AB Remodeling Device: endovascular treatment of highly selected complex cerebral aneurysms |
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