Abstract
BackgroundThe purpose of this study was to report our preliminary experience of stent-assisted coiling (SAC) of wide-necked intracranial aneurysms with a single microcatheter in patients with parent arteries that were small-caliber, with stenosis, or a very tortuous course.MethodsBetween March 2018 and December 2018, we treated 394 aneurysms in 359 patients with endovascular treatment. Among 197 aneurysms treated by SAC, there were 16 cases (all wide-necked unruptured aneurysms) treated by SAC with a single microcatheter and a Neuroform Atlas stent. Follow-up angiography was performed at 6 to 12 months after SAC, and clinical follow-up was performed from 6 to 12 months in all patients.ResultsThe reasons for SAC with a single 0.0165-in. microcatheter were small-caliber (n = 4), stenosis (n = 2), and very tortuous course (n = 10) of the parent arteries. There was no complication related to delivering or deploying the Neuroform Atlas stent as well as no failure of selecting aneurysm by cell-through technique. All patients had a modified Rankin score of 0 at discharge and at follow-up. Initial angiographic results showed six cases (37.5%) of complete occlusion. In follow-up angiographies, 12 cases (75.0%) achieved compete occlusion.ConclusionWhen performing SAC of wide-necked intracranial aneurysms in parent arteries with small-caliber, stenosis, or a very tortuous course, cell-through SAC using a single microcatheter and a Neuroform Atlas stent within a 5 Fr- (or smaller) guiding or intermediate catheter might be a useful option.
Highlights
The purpose of this study was to report our preliminary experience of stent-assisted coiling (SAC) of wide-necked intracranial aneurysms with a single microcatheter in patients with parent arteries that were smallcaliber, with stenosis, or a very tortuous course
Despite accumulated experience and improved understanding of the devices, endovascular treatment of widenecked intracranial aneurysms continues to be difficult to perform due to limitations arising from cerebrovascular anatomical structures [1]
A guiding catheter is placed in the internal carotid artery (ICA) for anterior circulation aneurysms and in the vertebral artery (VA) for posterior circulation aneurysms
Summary
The purpose of this study was to report our preliminary experience of stent-assisted coiling (SAC) of wide-necked intracranial aneurysms with a single microcatheter in patients with parent arteries that were smallcaliber, with stenosis, or a very tortuous course. When performing stentassisted coiling (SAC), a 6-Fr or larger guiding catheter is usually needed to support two microcatheters; one for stent delivery and the other for coil delivery. A guiding catheter is placed in the internal carotid artery (ICA) for anterior circulation aneurysms and in the vertebral artery (VA) for posterior circulation aneurysms. The purpose of this study was to report our preliminary experience with cell-through SAC for wide-necked intracranial aneurysms with a single 0.0165-in. Microcatheter in patients with parent arteries of small-caliber, with stenosis, or exhibiting a very tortuous course. The purpose of this study was to report our preliminary experience with cell-through SAC for wide-necked intracranial aneurysms with a single 0.0165-in. microcatheter in patients with parent arteries of small-caliber, with stenosis, or exhibiting a very tortuous course.
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