Y-stent assisted endovascular embolization in the treatment of wide-neck intracranial aneurysms

Purpose: In this report we aimed to present coil embolization after the placement of Y-configured intracranial stent in the treatment of wide-neck intracranial aneurysms.Materials and methods: Nine patients were included in this study. There were 5 females and 4 males aged from 48 to 66 (mean: 56) years. All aneurysms embolized with Y-configured stent assisted coil embolization, 3 were located in the anterior communicating artery, 4 in basillary artery, 2 in the middle cerebral artery. One of these nine patients had basillary artery aneurysm and followed because of subarachnoid hemorrhage. 8 patient had other neurological symptoms except of haemorrhage. Enterprise (J&J, Cordis, Miami Lakes, FL, USA) were replaced after Neuroform (Boston Scientific, Fremont, CA, USA) in six patients. Couple of Enterprise Y-figured stent were placed to 3 patients. Patients were treated with aspirin and clopidogrel one day before stenting except of hemorrhage.Results: İn eight of nine patients (88.9 %) Y-configured stent assisted coil embolization were performed successfully. All aneurysms were closed totally. İn one patient (11,1%) with a left middle cerebral artery bifurcation aneurysm, when an attempt was made at passing the second stent through the first Enterprise stent, the stent protruded inside the aneurysm. Because of this after the placement of second Enterprise stent the aneurysm was partially coiled to prevent the occlusion of the inferior truncus. After one month the patient had given up antiplatelet therapy and left temporal infarct occurred. This patient was hospitalized and discharged just with emotional symptoms. No procedural complications were seen in 8 patients after 15 and 18. (mean: 15,1) month angiographic follow-ups. No neurological complications were seen in 16 and 22, (mean: 19.1) month clinical follow-ups.Conclusion: Y-configured, stent assisted coil embolization in the treatment of wide-neck intracranial aneurysms is a safe and effective method for compliant patients receiving antiplatelet therapy from the viewpoint of short and midterm results.