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Y-Stent embolization technique for intracranial bifurcation aneurysms
Robert S Heller1, Jason P Rahal1, Adel M Malek1
1Department of Neurosurgery, Tufts Medical Center and Tufts University School of Medicine, 800 Washington Street, Boston, MA 02111, USA.
Summary
The Y-stent technique for wide-necked bifurcation aneurysms is effective and safe, achieving high occlusion rates. This complex procedure offers a durable solution for intracranial aneurysms when other methods fail.
Area of Science:
- Neurosurgery
- Interventional Radiology
- Vascular Neurology
Background:
- Wide-necked bifurcation aneurysms pose treatment challenges.
- The Y-stent technique offers a potential solution by modifying hemodynamics.
- Evaluating the efficacy and safety of Y-stent supported coil embolization is crucial.
Purpose of the Study:
- To assess the single-center efficacy and safety of Y-stent supported aneurysm coil embolization.
- To determine occlusion rates and neurological adverse events associated with the Y-stent technique.
Main Methods:
- Retrospective analysis of 20 consecutive patients undergoing Y-stent supported coiling (September 2006 - December 2012).
- Evaluation of procedural success, complications, and follow-up data (mean clinical 20.0 months, radiographic 18.5 months).
- Assessment of aneurysm occlusion using Raymond grade.
Main Results:
- Technically successful Y-stent supported coiling in all 20 patients.
- Complete aneurysm occlusion in 95% (19/20) initially.
- No peri-procedural neurological complications; 15% (3/20) required re-treatment for recanalization.
- At latest follow-up, 80% achieved Raymond grade I occlusion.
Conclusions:
- Y-stenting for complex intracranial aneurysms demonstrates effectiveness in achieving durable occlusion.
- The Y-stent technique offers an acceptable safety profile for challenging aneurysms.
- Consider Y-stenting when single-stent techniques are insufficient or not feasible.
