Distal stenting technique for coil embolization of early branch aneurysms of middle cerebral artery - 24/04/24
Graphical abstract |
Highlights |
• | When treating early branch aneurysms of the middle cerebral artery with the small diameter and acute angle of the branches with coil embolization, adequate deployment of the stent can sometimes be challenging. |
• | Distal stenting technique is to align the proximal marker of the open-cell stent with the proximal half of the aneurysmal neck, and the stent is deployed only distal to the aneurysmal neck. |
• | The stent was successfully deployed in all 15 aneurysms (100%). Intraprocedural problems occurred in two cases (12.5%), but no clinical complications occurred. Two patients (20.0%) had minor recanalization, but no additional treatment was required. |
• | Treatment of early branch aneurysms with coil embolization using the distal stenting technique can be considered an effective and safe method. |
Abstract |
Background and purpose |
Stent-assisted coil embolization of early branch aneurysms of the middle cerebral artery (MCA) can sometimes be challenging due to the small diameter and acute angle of the branches. This study aimed to analyze the treatment results and report the feasibility and outcomes of the distal stenting technique for these aneurysms.
Materials and methods |
The distal stenting technique was used for 15 wide-neck MCA aneurysms (females, 10; males, 5; mean age, 65.1 years) originating from the early branch between December 2018 and October 2021. The average sizes of the dome, depth, and neck of the aneurysms were 4.17 mm (range: 2.99–6.21 mm), 2.86 mm (range: 1.82–3.72 mm), and 3.42 mm (range: 2.44–4.32 mm), respectively.
Results |
The average diameter of the stents was 4.0 mm (3.0 mm, 3; 4.0 mm, 6; 4.5 mm, 6). Stents were successfully deployed in all 15 aneurysms (100%). The average length of the procedure was 69 min (range: 45–117 min). On postoperative angiography, nine (60.0%) aneurysms were completely occluded, four (26.7%) had neck remnants, and two (13.3%) had contrast flow in the sac. During the procedure, vasospasm and thrombus formation occurred in one case each, but no neurological sequelae were observed. On follow-up digital subtraction angiography of the 10 aneurysms after an average of 13.7 months (range: 12–18 months), the branches were well preserved, and neck remnants were noted in four aneurysms (40.0%). No thromboembolic events occurred during the clinical follow-up.
Conclusion |
The distal stenting technique using an open-cell stent can be a good option for coil embolization of early branch MCA aneurysms.
Le texte complet de cet article est disponible en PDF.Keywords : Aneurysm, Coil, Stent, Technique
Plan
Vol 51 - N° 3
P. 231-235 - mai 2024 Retour au numéro
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