Small Tenuous Intracranial Arteries Can Well Tolerate the Deployment of 2 Stents in Y Configuration or an Overlapping Manner in Treating Intracranial Aneurysms.

Authors:
Ji-Wei Wang
Ji-Wei Wang
Fudan University
China
Jian-Feng Liu
Jian-Feng Liu
Zhejiang Normal University
China
Hui Li
Hui Li
Xiangya Hospital
Sumy | Ukraine
Song-Tao Yang
Song-Tao Yang
Jilin University
China

World Neurosurg 2018 Aug 2;116:e1098-e1104. Epub 2018 Jun 2.

Department of Neurosurgery, The First Hospital, Hebei Medical University, Shijiazhuang, Hebei Province, China.

Objective: To investigate parent vessel response to deployment of 2 stents for treatment of cerebral aneurysms.

Methods: Fifteen patients (11 women and 4 men; age range, 25-83 years) with 18 wide-necked intracranial aneurysms were treated with 2 stents with or without subsequent coiling. The vascular diameter was measured and compared within the native parent artery, and the single stent and double stent were measured and compared before and immediately after stenting and at angiographic follow-up.

Results: Thirty stents were deployed. Before stenting, the mean vessel diameter was 3.4 ± 0.21 mm at point A, 3.06 ± 0.18 mm at point B, 3.16 ± 0.21 mm at point C, 2.67 ± 0.27 mm at point D, and 2.56 ± 0.23 mm at point E. The deployment of 2 stents resulted in statistically significant increases in both the average vascular diameter and cross-sectional area at points C (3.51 ± 0.22 mm, P = 0.0006; and 9.76 ± 1.17 mm, P = 0.001, respectively) and E (2.88 ± 0.32 mm, P = 0.01; and 7.28 ± 1.46 mm, P = 0.02, respectively) compared with prestenting. At angiographic follow-ups, compared with before stenting, significant increases were documented at point C (3.42 ± 0.22 mm and 9.42 ± 1.37 mm, respectively) at first angiographic follow-up but at points A (3.62 ± 0.45 mm and 10.51 ± 2.37 mm, respectively) and B (3.26 ± 0.24 mm and 8.47±1.26 mm, respectively) at second angiographic follow-up. No significant vascular stenosis was demonstrated at the double-stent segment compared with the single-stent or native artery segments.

Conclusions: The small tenuous cerebral arteries can well tolerate the deployment of 2 stents for the treatment of intracranial aneurysms.

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http://dx.doi.org/10.1016/j.wneu.2018.05.179DOI Listing

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August 2018
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