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Stepwise stent deployment technique for tandem intracranial aneurysms: a review of 21 cases
Yi-Bin Fang1, Zhao-Long Zhang1, Peng-Fei Yang1
1Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China, 200433.
Objectives:
We performed this study to report our experience using a stepwise stent deployment technique for the treatment of tandem intracranial aneurysms.
Methods:
Patients with intracranial tandem aneurysms that were treated with a stepwise stent deployment technique between May 2009 and June 2013 were retrospectively reviewed.
Results:
Twenty-one patients with 42 tandem aneurysms were identified (11 men, 10 women), with a mean age of 53.7 years (range, 17-82 years). Subarachnoid haemorrhage was confirmed in 12 patients using computed tomography at onset. Complete occlusion was achieved in 20 of the aneurysms (47.6%) after the procedure, neck remnant in 9 (21.4%), and aneurysm remnant in 13 (31.0%). The perioperative complications included in-stent thrombosis in one case and vasospasm in two cases, none of which left a permanent neurological deficit. The modified Rankin Scale (mRS) score at discharge was 0-2 in 20 cases and 3 in one case. The follow-up angiograms available for 17 patients showed complete occlusion in 26 aneurysms, improved in 4, and stable in 4. All of the patients had mRS scores of 0-1 during the clinical follow-up period.
Conclusions:
The stepwise stent deployment technique is feasible and helpful in the treatment of intracranial tandem aneurysms.
Key Points:
• Treating wide-necked intracranial aneurysms with stent-assisted coiling is preferable. • Tandem wide-necked intracranial aneurysms can be treated with a single stent. • Stepwise stent deployment is technically feasible for embolizing tandem intracranial aneurysms.
