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E-007 Y-Stenting for the treatment of basilar apex aneurysms
  1. F Albuquerque,
  2. C McDougall
  1. Barrow Neurological Institute, Phoenix, Arizona, USA

Abstract

Introduction Despite advances in surgical and endovascular treatment of intracranial aneurysms, the management of wide necked basilar tip aneurysms poses substantial treatment challenges. Y stenting, in which one stent is deployed through the side wall tines of a previously placed stent, is a feasible adjunct to coiling of these aneurysms. Case series describing this technique are small with limited follow-up. We describe our experience with the Y stent assisted, coil embolization of basilar tip aneurysms in the largest case series to date with medium term follow-up data.

Methods A review of our prospectively maintained database from 2004 to 2009 was performed to assess technical factors associated with treatment, complications and radiographic follow-up of patients undergoing Y stenting for basilar apex aneurysms.

Results 11 patients with wide necked basilar tip aneurysms were treated. Average follow-up was 13 months. Post-procedure surveillance was carried out by MR angiography (n=6), cerebral angiogram (n=9) or CT angiography (n=1), with several patients undergoing multiple types of radiographic follow-up. All patients’ aneurysms were completely or nearly completely (>95%) occluded at the time of treatment. No patient required retreatment. One patient suffered an asymptomatic vertebral artery dissection that required stenting and another suffered a minor stroke but recovered completely.

Conclusion Y stenting is a viable treatment modality for this complex subgroup of aneurysms. Our series demonstrated the safety of this technique, with no patients suffering permanent complications. While the efficacy of Y stenting has yet to be established, medium term radiographic follow-up suggests durable results.

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Footnotes

  • Competing interests FA—Micrus, EV3, Advanced Medical Devices Inc.

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