Article Figures & Data
Figures
- Fig 1.
Initial 3D reconstruction image of rotational angiogram (A) shows small wide-neck MCA trifurcation aneurysm. Posttreatment 3D reconstruction image of flat panel CTA (B) demonstrates the Y-configuration of the 2 stents placed within the MCA branches crossing the neck of the aneurysm, which is still filling in between. 3D reconstruction image of the flat panel CTA (C) obtained at 1-month control and 3D image of rotational angiogram at 1-year control (D) showing complete occlusion of the aneurysm and reconstruction of the trifurcation.
- Fig 2.
Pretreatment left vertebral artery angiogram in oblique projection (A) and 3D reconstruction image of rotational angiogram (B) show the basilar tip aneurysm without a definable neck. Posttreatment angiogram (C), nonsubtracted view, shows the “Y”-configured stents extending into the both posterior cerebral arteries from the basilar trunk. The 2-year follow-up angiogram (D) and 3D reconstruction image of rotational angiogram (E) demonstrate completely remodeled basilar bifurcation with the aneurysm sac disappeared and occlusion of the right P1.
- Fig 3.
T2-weighted axial MR image (A) shows the giant basilar tip aneurysm causing mass effect and increased signal intensity in the brain stem. Pretreatment right vertebral artery angiogram in Towne projection (B) demonstrates the large and wide-neck basilar tip aneurysm. Posttreatment coronal (C) and axial (D) 3D reconstruction images of flat panel CTA demonstrate the “Y”-configuration of double stent placement. The 1-month follow-up axial CTA image (E) shows the significant decrease in size of the patent aneurysm lumen. The 2-year control angiogram (F), nonsubtracted view, shows progressive thrombosis and change in the shape of the aneurysm sac so that it became a bilobulated, small aneurysm. The larger lobule was coiled in the same session, and the small lobule is still being followed. G, Angiogram, subtracted image obtained after coiling.
Tables
Summary of relevant clinical and angiographic data in 8 patients with wide-neck bifurcation aneurysms treated using Y-stent flow diversion technique
Case No. Age (yr), Sex Aneurysm Location Aneurysm Type Aneurysm Size Microcatheter Jail before Stent Placement Latest Angiographic Follow-Up Final Angiographic Result Initial Presentation Final Clinical Result (modified Rankin Scale) 1a 50, M MCA bifurcation R Small Yes 1 yr Complete occlusion SAH, failed surgical clipping 0 2 48, M Basilar tip R Large No 2 yr Complete occlusion SAH, medical treatment, headache 0 3b 41, F Basilar tip U Giant No 2 yr Residual filling Mass effect, aglutition 0 4 53, M MCA bifurcation U Small Yes 1 yr Complete occlusion Asymptomatic 0 5 49, M MCA bifurcation U Small No 1 yr Complete occlusion Headache 0 6 44, F MCA bifurcation U Small No 6 mo Complete occlusion Headache 0 7 43, M MCA bifurcation U Small No 6 mo Complete occlusion Asymptomatic 0 8 45, F Basilar tip U Giant No 3 mo Residual filling Headache, mass effect, aglutition, and ptosis 1 -
a Patient had a previous failed surgical treatment attempt.
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b Patient needed additional coiling.
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