Du Elizabeth Hai Yen, Shankar Jai Jai Shiva
Department of Diagnostic Radiology, Dalhousie University, Halifax, Nova Scotia, Canada.
Division of Neuroradiology, Department of Diagnostic Imaging, QE II Health Sciences Center, Halifax, Nova Scotia, Canada.
J Neurointerv Surg. 2016 Dec;8(12):1256-1259. doi: 10.1136/neurintsurg-2015-012246. Epub 2016 Feb 4.
Wide-necked bifurcation intracranial aneurysms have traditionally not been amenable to coil embolization with the use of a single stent due to the high risk of coil prolapse. Y-configuration double stent-assisted coil embolization ('Y-stenting') of this aneurysm type has been shown to have generally good clinical outcomes, although the technique is complex with various challenges described in the literature. The compliant and flexible closed-cell design of braided stents such as the LVIS Jr allows for the creation of a 'shelf' across the aneurysm neck sufficient to prevent coil prolapse. We describe this novel 'shelf' technique and present a small case series of LVIS Jr stent-assisted wide-necked bifurcation intracranial aneurysm coiling in eight patients. Our small, albeit important, case series demonstrates that the 'shelf' technique is feasible and safe with very good short-term clinical and angiographic outcomes, and may obviate the need for Y-stenting.
由于存在较高的弹簧圈脱垂风险，传统上宽颈分叉部颅内动脉瘤不适合使用单个支架进行弹簧圈栓塞治疗。尽管文献中描述该技术复杂且存在各种挑战，但这种动脉瘤类型的Y形双支架辅助弹簧圈栓塞术（“Y形支架置入术”）已显示出总体良好的临床效果。编织支架（如LVIS Jr）的顺应性和柔韧性闭孔设计允许在动脉瘤颈部创建一个足以防止弹簧圈脱垂的“支架平台”。我们描述了这种新颖的“支架平台”技术，并展示了一个小型病例系列，该系列包含8例接受LVIS Jr支架辅助宽颈分叉部颅内动脉瘤弹簧圈栓塞术的患者。我们这个虽小但很重要的病例系列表明，“支架平台”技术是可行且安全的，具有非常好的短期临床和血管造影结果，并且可能无需进行Y形支架置入术。
