Y-stent assisted coiling of bifurcation aneurysms with Enterprise stent: long-term follow-up.
BACKGROUND
Y-stent assisted coiling has been proposed for the treatment of wide-neck bifurcation aneurysms, but there are many technical variations. We report our single-center experience of Y-stent assisted coiling of bifurcation aneurysms with the closed cell Enterprise stent in order to evaluate the safety and long-term results of this technique. The literature on Y-stenting and its hemodynamic effects are reviewed.


METHODS
Fifty-two consecutive patients with wide-neck bifurcation aneurysms underwent Y-stent assisted coiling with two Enterprise stents. The procedure was completed in 48 cases (92.3%) and technical failure occurred in 4 cases (7.3%). Cases performed with other stents were excluded. All procedures were performed under double antiplatelet therapy. Periodic clinical and neuroradiological follow-up was performed.


RESULTS
Mean neuroradiological follow-up time was 26 months. Complete immediate occlusion was obtained in 87.5% of patients. Two remnants had regrown at follow-up and were recoiled, achieving complete occlusion. The late neuroradiological occlusion rate was: complete occlusion 93.6%, neck remnant 4.3%, sac remnant 2.1%. No in-stent stenosis was detected at follow-up. Among the 48 procedures, two complications occurred (4.2%). Mortality was 2.1%. No delayed ischemic stroke occurred.


CONCLUSIONS
Y-stent assisted coiling has a high immediate occlusion rate and very good long-term stability. The procedure is relatively safe, although the complication and mortality rates are not negligible. Two Enterprise stents can be safely used for Y-stenting and, indeed, offer the advantage of easier catheterization, delivery and deployment into distal and tortuous vessels than open cell stents.
['Limbucci|Nicola|N|', 'Renieri|Leonardo|L|', 'Nappini|Sergio|S|', 'Consoli|Arturo|A|', 'Rosi|Andrea|A|', 'Mangiafico|Salvatore|S|']
D002533:Cerebral Angiography D005260:Female D005500:Follow-Up Studies D006801:Humans D002532:Intracranial Aneurysm D008297:Male D008875:Middle Aged D012189:Retrospective Studies D015607:Stents D013997:Time Factors
Aneurysm Stent Technique Intervention