Stent-assisted coiling strategies for the treatment of wide-necked basilar artery bifurcation aneurysms

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• 作者：Jian-Zhong Zhang¹ ; Peng-Fei Yang¹ ; Qing-Hai Huang ; Yi Xu ; Bo Hong ; Wen-Yuan Zhao ; Jian-Min Liu ; ^{chstroke@163.com" class="auth_mail}
• 关键词：Basilar artery bifurcation aneurysm ; Endovascular ; Stent
• 刊名：Journal of Clinical Neuroscience
• 出版年：June 2014
• 年：2014
• 卷：21
• 期：6
• 页码：962-967
• 全文大小：1680 K

文摘

Stent-assisted coiling is now the preferred treatment option for wide-necked basilar artery bifurcation aneurysms (BABA). However, the optimal choice of specific treatment strategies is still not well documented. In this paper, based on the “two-neck” theory of BABA, we classified the stent-assisted coiling treatment of BABA into three types: unilateral stent-assisted coiling, unilateral stent plus contralateral microcatheter or microwire-assisted coiling, and bilateral stent-assisted coiling. We assessed the feasibility and effectiveness of different stent-assisted coiling strategies for the treatment of BABA. Twenty-three BABA patients treated with stent-assisted coiling between May 2003 and September 2012 were included. Of the 23 aneurysms, 16 were treated with unilateral stent-assisted coiling, two were treated with unilateral stent and microcatheter or microwire-assisted coiling, and five were treated with bilateral stent-assisted coiling. All 23 BABA were successfully embolized, with a technical success rate of 100%. According to the Raymond classification, the immediate procedural outcome was grade I in nine patients, grade II (neck residue) in four patients and grade III (body filling) in 10 patients. The rate of procedure-related complications was 4.3% (1/23), where intra-operative hemorrhage occurred during coiling due to rupture of the aneurysm. Of the 23 patients, 16 (69.6%) had angiographic follow-up. The mean follow-up duration was 13.5 months (range 1–46 months). Angiographic follow-up showed complete occlusion in 10 patients (62.5%), improvement in two patients (12.5%), stability in three patients (18.7%), and recanalization in one patient (6.25%). The various stent-assisted coiling strategies available at present are feasible and effective for the treatment of wide-necked BABA.