Article ; Online: Y-Configuration Stenting for Coil Embolization of Complex Intracranial Aneurysms: Distinguishing Between Use of Crossing-Y and Kissing-Y.
2020 Volume 146, Page(s) e1054–e1062
Abstract: Objective: Coil embolization with Y stenting is recognized as a suitable treatment for complex ... wide-necked aneurysms. Y stenting comprises crossing-Y stenting, in which a stent is passed ... through the interstices of another stent, and kissing-Y stenting, in which 2 stents are arranged in parallel. The purpose ...
| Abstract | Objective: Coil embolization with Y stenting is recognized as a suitable treatment for complex wide-necked aneurysms. Y stenting comprises crossing-Y stenting, in which a stent is passed through the interstices of another stent, and kissing-Y stenting, in which 2 stents are arranged in parallel. The purpose of this study was to elucidate how to distinguish between use of the 2 Y-stenting techniques. Methods: Clinical and angiographic data of patients who underwent coil embolization with Y stenting at our department from 2015 to 2019 were retrospectively analyzed. Basic characteristics, endovascular procedure, complications, and outcomes were compared between kissing-Y and crossing-Y stenting groups. Results: Thirty-eight intracranial aneurysms in 38 consecutive patients were included in this study. Nineteen patients (50%) were treated with coil embolization with kissing-Y stenting and 19 (50%) with crossing-Y. Endovascular procedures were successfully performed in all but 1 patient, in the kissing-Y group, who had stent migration. One hemorrhage (2.6%) recurred 12 months after coiling with kissing-Y stenting. Angiographic follow-up (mean, 15.8 months) was available in 35 patients. Adequate occlusion was shown in 14 patients (77.8%) and 13 patients (76.5%) in the kissing-Y and crossing-Y groups, respectively. Larger, wider-necked, and more proximal aneurysms were treated with kissing-Y stenting than with crossing-Y stenting, although there were no significant differences between the groups in complication rates or clinical outcomes. Conclusions: Kissing-Y and crossing-Y stenting of intracranial aneurysms were both feasible and yielded reasonable angiographic and clinical results. The choice between the kissing-Y or crossing-Y-stenting technique should be decided according to the angioarchitecture of targeted aneurysms. |
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| MeSH term(s) | Aged ; Aged, 80 and over ; Aneurysm, Ruptured/surgery ; Asymptomatic Diseases ; Cerebral Angiography ; Embolization, Therapeutic ; Endovascular Procedures/methods ; Female ; Headache/physiopathology ; Humans ; Hydrocephalus/physiopathology ; Intracranial Aneurysm/physiopathology ; Intracranial Aneurysm/surgery ; Male ; Middle Aged ; Ocular Motility Disorders/physiopathology ; Prosthesis Failure ; Retrospective Studies ; Stents ; Subarachnoid Hemorrhage/surgery ; Vision Disorders/physiopathology |
| Language | English |
| Publishing date | 2020-11-24 |
| Publishing country | United States |
| Document type | Journal Article |
| ZDB-ID | 2534351-8 |
| ISSN | 1878-8769 ; 1878-8750 |
| ISSN (online) | 1878-8769 |
| ISSN | 1878-8750 |
| DOI | 10.1016/j.wneu.2020.11.092 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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