Coil Embolization for Cerebral Aneurysms Using a Semi-Jailing Technique and Open-Cell Stent

Area of Science:

• Interventional Neuroradiology
• Vascular Surgery
• Biomedical Engineering

Background:

• The semi-jailing technique (SJT) traditionally uses closed-cell stents for embolization, but faces challenges like poor expansion and thrombosis in curved vessels.
• This study introduces and evaluates the use of open-cell stents in SJT, enabling stent delivery via microcatheter.

Purpose of the Study:

• To compare the performance of open-cell versus closed-cell stents in the semi-jailing technique (SJT) for internal carotid artery aneurysm embolization.
• To assess treatment outcomes, including embolization rates and stent apposition, in patients undergoing SJT with different stent types.

Main Methods:

• Comparative analysis using silicone vessel models to evaluate stent behavior.
• Retrospective study of 43 patients with internal carotid artery aneurysms treated with SJT, divided into open-cell (n=24) and closed-cell (n=19) stent groups.

Main Results:

• Open-cell stents allowed shorter deployment lengths and showed a trend towards higher complete embolization rates (54.2% vs. 26.3%).
• Significantly lower stent malapposition was observed with open-cell stents (0% vs. 31.6%, P < 0.01).
• Both groups had good functional outcomes (mRS 0-1), with one ischemic complication in the closed-cell group and one hemorrhagic complication in the open-cell group.

Conclusions:

• Open-cell stents may offer advantages in SJT for internal carotid artery aneurysms due to improved coil delivery and vessel wall apposition.
• Despite the disadvantage of an unresheathable design, the benefits of shorter deployment length and better apposition warrant consideration.