Safety and Efficacy of Y- Stenting with Laser Cut Open Cell Stents in Complex Wide Neck Bifurcation Aneurysms

Document Type : Original Article

Authors

1 Department of Neurosurgery, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt.

2 Department of Neurosurgery, Faculty of Medicine, Tanta University, Tanta, Egypt.

Abstract

Background: Y-stenting provide a coiling support and protection to the parent artery and its branches. However, the interventional approach requires many steps and represented a technical challenge. This is attributed to the passage of the second stent through the interstices of the first one. In addition, Y-stent leaves a large amount of metal in the healthy parent artery.
Aim and objectives: This study aimed to assess the safety and efficacy of Y-stenting with Laser cut open cell stents in complex wide neck bifurcation aneurysms.
Subjects and Methods: This prospective clinical study included 30 patients, who were selected from the Neuro-Psychiatry center, Tanta university. All were submitted to standard clinical pre-interventional assessment. After the intervention the primary and secondary outcomes were documented. The primary outcome was the successful Application of Y-stenting with laser cut open cell stents and periprocedural complications. The secondary outcomes included the safety and efficacy of Y-stenting with laser-cut open cell stents at follow-up 6 and 12 months of follow up.
Results: At six months after intervention, there were 26 patients [86.7%] with complete occlusion, 2 patients [6.7%] with Neck remnant, 2 patients [6.7%] with recurrence and needs retreatment. After one year, there was 28 patients [93.3%] with complete occlusion, 2 patients [6.7%] had Neck remnant. The risk factors for stroke were hypertension among 7 patients [23.3%], diabetes mellitus in 3 patients [10.0%], 7 patients [23.3%] had dyslipidemia and smoking was reported among 7 patients [23.3%].
Conclusion: Neuroform Atlas stent achieves a safe and effective Y-stenting operation by combining the benefits of open-cell architecture with low-profile deployment microcatheters. This study's positive angiographic and clinical results showed that wide-necked complicated bifurcation aneurysms can be effectively treated endovascularly using Y-stent-assisted coiling using Neuroform Atlas stents. 

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