Related Experiment Video

Updated: Jul 21, 2025

Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment
18:50

Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment

Published on: September 25, 2009

13.8K

A Case of Coil Embolization with Crossing Y-Configuration Stenting for a Recurrent IC-PC Aneurysm after Clipping

Shinji Sato1, Yasuaki Kokubo1, Kanako Kawanami1

  • 1Department of Neurosurgery, Yamagata University Faculty of Medicine, Yamagata, Yamagata, Japan.

Journal of Neuroendovascular Therapy
|July 28, 2023
PubMed

Insights

Coil embolization using Y-configuration stenting effectively treated a recurrent internal carotid-posterior communicating artery aneurysm after multiple failed clipping surgeries. This minimally invasive technique offers a viable solution for complex, wide-necked aneurysm recurrences.

Area of Science:

  • Neurosurgery
  • Interventional Neuroradiology
  • Vascular Neurology

Background:

  • Recurrent intracranial aneurysms, particularly internal carotid-posterior communicating artery (IC-PC) aneurysms, pose significant treatment challenges.
  • Previous surgical clipping can lead to adhesions, complicating re-intervention.
  • Wide-necked and recurrent aneurysms often require advanced endovascular techniques.

Observation:

  • A 57-year-old woman presented with multiple recurrences of IC-PC aneurysms after two prior clipping surgeries, experiencing subarachnoid hemorrhages.
  • The recurrent right IC-PC aneurysm was wide-necked and located distally, with significant surgical adhesions anticipated.
  • A novel approach using crossing Y-configuration stenting with Neuroform Atlas stents was employed for coil embolization.

Findings:

  • The Y-configuration stenting technique successfully facilitated coil embolization of the wide-necked recurrent IC-PC aneurysm.
  • The procedure achieved tight packing with a minimal residual neck, obliterating the aneurysm.
  • Post-procedural DSA follow-up at one year showed no aneurysm compaction or recurrence, with good visualization of the posterior communicating artery.

Implications:

  • Coil embolization combined with crossing Y-configuration stenting is a feasible and effective treatment for recurrent, wide-necked IC-PC aneurysms.
  • This endovascular strategy provides a less invasive alternative to repeat open surgery in complex cases.
  • The technique ensures preservation of parent artery and branch vessel patency, crucial for long-term outcomes.
Abstract

Keywords:
coil embolizationcrossing Y-configuration stentinginternal carotid-posterior communicating artery aneurysmrecurrent aneurysm

More Related Videos

Creation of Two Saccular Elastase-Digested Aneurysms with Different Hemodynamics in One Rabbit07:04

Creation of Two Saccular Elastase-Digested Aneurysms with Different Hemodynamics in One Rabbit

Published on: April 15, 2021

2.1K
Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms11:58

Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms

Published on: August 11, 2015

15.6K

Related Concept Videos

Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
10
Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
11
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
10
Aneurysm IV: Nursing Management01:22

Aneurysm IV: Nursing Management

Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
8