Article ; Online: The Geometry of Y-Stent Configurations Used for Wide-Necked Aneurysm Treatment: Analyzing Double-Barrel Stents In Vitro Using Flat-Panel Computed Tomography.
2021 Volume 151, Page(s) e363–e371
Abstract: ... a Y configuration stent. A similar stent configuration, termed kissing/double-barrel (KDB), is used ...
Abstract | Background: Stent-assisted coil embolization of wide-necked bifurcation aneurysms often employs a Y configuration stent. A similar stent configuration, termed kissing/double-barrel (KDB), is used often at the aortoiliac bifurcation. Studies of KDB stents in aortoiliac disease show that rates of thromboembolic complications vary with the cross-sectional geometry of the stent pair, a function of the radial crush resistive force of each stent. We assessed cross-sectional geometry of intracranial stent pairs in an in vitro model of the basilar artery using flat-panel computed tomography. Methods: In a silicone model of a wide-necked basilar tip aneurysm, 6 simulated KDB stent deployment trials were performed using combinations of 5 stents (Enterprise 1, Enterprise 2, Neuroform Atlas, LVIS, LVIS Jr.). Flat-panel computed tomography reconstructions were used to assess cross-sectional stent geometry. Relative conformability, defined by ovalization and D-ratio, radial crush resistive force (predicted vs. actual), and radial mismatch fraction were compared by stent type (braided vs. laser-cut). Results: Several distinct forms of cross-sectional stent geometry were observed. Braided stents had lower ovalization and D-ratio (P = 0.015) than laser-cut stents. The Neuroform Atlas/LVIS combination yielded the lowest radial mismatch fraction (19.7% vs. mean 44.3% ± 0.7%). Braided stents tended to have a deployed stent radius closer to the expected (nominal) diameter (i.e., higher relative crush resistive force) than laser-cut stents (measured vs. nominal diameter discrepancy +38.6% ± 21.1% vs. -10.7% ±16.1%, P = 0.14). Conclusions: In constant anatomy, cross-sectional geometry of the KDB stent configuration will vary depending on the design and structure of the stents employed. |
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MeSH term(s) | Embolization, Therapeutic/methods ; Endovascular Procedures/methods ; Humans ; Intracranial Aneurysm/diagnostic imaging ; Intracranial Aneurysm/surgery ; Models, Neurological ; Stents ; Tomography, X-Ray Computed |
Language | English |
Publishing date | 2021-04-19 |
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.2021.04.042 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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