Nonoverlapping Y-Configuration Stenting Technique With Dual Closed-Cell Stents in Wide-Neck Basilar Tip Aneurysms

Abstract

ABSTRACT BACKGROUND: Stent-assisted coiling is increasingly used to treat wide-neck intracranial aneurysms to protect the lumen of the parent artery from coil protrusion. This technique is insufficient for treating some aneurysms, depending on their configurations. OBJECTIVE: To describe a variant of the Y-configuration stent-assisted coiling technique for the treatment of basilar tip aneurysms with wide necks. METHODS: This technique, called the nonoverlapping Y stenting technique, consists of the deployment of a closed-cell self-expandable stent from the basilar trunk to a posterior cerebral artery and then placement of a second stent from the basilar bifurcation to the other posterior cerebral artery without overlapping the first stent. The proximal flared portion of the second stent was located at the neck of the aneurysm. Coil embolization was performed under dual-stent protection. RESULTS: We successfully filled wide-neck aneurysms with coils under stent protection by forming a bridge across the aneurysmal neck without overlapping 2 closed-cell stents. Six basilar tip aneurysms were successfully treated with this technique. CONCLUSION: The nonoverlapping Y stenting technique is a good alternative to traditional stent-assisted coiling. This technique is particularly suitable for the treatment of broad-neck bifurcation aneurysms.