Y-Stent-Assisted Coil Embolisation of Wide-Necked Aneurysms: Cases
Journal name: The Malaysian Journal of Medical Sciences
Original article title: Y-Stent–Assisted Coil Embolisation of Wide-Necked Aneurysms Using a New Fully Retrievable and Detachable Intracranial Stent: Report of Two Cases
The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access journal published online at least six times a year. It covers all aspects of medical sciences and prioritizes high-quality research.
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Ahmad Sobri Muda, Ahmad Razali Md Ralib, Yazmin Yaacob, Rozman Zakaria, Azizi Abu Bakar
The Malaysian Journal of Medical Sciences:
(A peer-reviewed, open-access journal)
Full text available for: Y-Stent–Assisted Coil Embolisation of Wide-Necked Aneurysms Using a New Fully Retrievable and Detachable Intracranial Stent: Report of Two Cases
Year: 2011
Copyright (license): CC BY 4.0
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Summary of article contents:
Introduction
Endovascular treatment (EVT) has become a standard approach for managing both ruptured and unruptured intracranial aneurysms, particularly those with wide necks, which challenge endovascular therapists. Traditional methods for treating these types of aneurysms include balloon remodeling, jailed microcatheters, and various stent-assisted techniques, with a focus on minimizing complications. One promising advancement is the use of the Y-stent–assisted technique, notably employing the new Solitaire AB™ stent for coil embolization. This report outlines two cases highlighting the effectiveness of this technique in managing wide-necked bifurcation aneurysms.
Advantages of the Solitaire AB™ Stent
The Solitaire AB™ stent's unique design offers significant advantages due to its fully retrievable and detachable features. Unlike traditional stents, which cannot be repositioned after deployment, the Solitaire AB™ can be adjusted if flow into branches is compromised, as demonstrated in the first case involving a basilar tip aneurysm. The ease with which a microcatheter can be navigated through the stent's wider cell design facilitates the creation of a Y configuration for simultaneous stent deployment without obstruction. These attributes enhance the safety and efficacy of the Y-stent–assisted coil embolization procedure, allowing for effective control of blood flow patterns and promoting thrombosis within the aneurysm.
Conclusion
The use of Y-stent–assisted coil embolization with the Solitaire AB™ stent proves to be a safe and effective technique for treating wide-necked bifurcation aneurysms. The ability to reposition a fully deployed stent, coupled with the ease of navigating microcatheters through its design, presents a significant advancement in the management of these complex vascular conditions. This technique offers promising outcomes for patients, with minimal complications associated with stent deployment, supporting its ongoing application in clinical practice.
FAQ section (important questions/answers):
What challenges do wide-necked aneurysms present in endovascular treatment?
Wide-necked aneurysms are difficult to treat with endovascular techniques due to their anatomy. They require specialized methods like stent-assisted coil embolization to achieve optimal outcomes and prevent complications during the procedure, unlike simpler aneurysms.
What is the Y-stent-assisted coil embolization technique?
The Y-stent-assisted coil embolization technique involves placing two stents in a Y configuration across the neck of a wide-necked aneurysm, providing structural support for coil embolization and effective blood flow disruption to enhance thrombosis.
How does the Solitaire AB™ stent differ from other stents?
The Solitaire AB™ stent is fully retrievable and detachable, allowing repositioning if flow compromise occurs during deployment. Its design features large cell struts, facilitating easier microcatheter navigation compared to other stents.
What was the outcome for the patients treated with the Y-stent technique?
One patient developed serious complications leading to death, while the second patient experienced successful treatment with a significant reduction in aneurysm opacification at follow-up. Both demonstrated the potential risks and benefits associated with this technique.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Y-Stent-Assisted Coil Embolisation of Wide-Necked Aneurysms: Cases”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Arrow:
In the context of angiographic images presented in the cases, 'arrow' refers to the indicators used to denote the location of the aneurysm or critical structures in the vascular system. The arrows help guide the viewer’s attention to specific areas needing focus during evaluation of the treatment outcomes and the anatomy of the aneurysms.
2) Post:
The term 'post' signifies the period or actions taken after a specific event, in this case, referring to post-procedure outcomes, including post-embolization angiographic runs. It is crucial for evaluating the success of the endovascular treatment techniques and the stability of the treated aneurysms observed in follow-up assessments.
3) Visit:
Visit refers to patient follow-ups after surgical or endovascular interventions. These visits allow healthcare professionals to monitor recovery, assess potential complications, and evaluate the treatment’s effectiveness over time, thereby enhancing patient care and informing future medical decisions based on the patient’s progress.
4) Science (Scientific):
The term 'scientific' denotes the systematic study and application of knowledge based on empirical evidence. In this context, it underscores the importance of rigorous methodologies and research in understanding endovascular therapy’s effectiveness, reinforcing the value of evidence-based practices in treating intracranial aneurysms and improving patient outcomes.
5) Study (Studying):
Study refers to a detailed investigation or analysis aimed at understanding a specific medical phenomenon or procedure, such as the efficacy of Y-stent-assisted coil embolization. It highlights the ongoing quest within medical fields to improve techniques, patient safety, and treatment outcomes through careful evaluation of clinical practices.
6) Wall:
Wall relates to the vascular wall, critical in the context of medical discussions about aneurysms. It underscores the importance of understanding vessel wall properties and behaviors during stent deployment and coil embolization, which significantly influence the risk of complications and the success of the procedure.
7) Discussion:
Discussion refers to the analytical discussion presented in the article regarding the outcomes and implications of using Solitaire AB™ stents in treating wide-necked aneurysms. It serves as a platform to synthesize clinical experiences, contrasting various techniques, and encourages further exploration and dialogue in the medical community about effective treatments.
8) Knowledge:
Knowledge represents the accumulated understanding and information regarding medical practices, particularly in the context of endovascular treatments. It emphasizes the necessity for practitioners to stay informed and adapt to advances in technology and procedures, honing their skills and expertise for improved patient care and treatment strategies.
9) Disease:
Disease denotes a pathological condition affecting the body, in this case, cerebral aneurysms. A thorough understanding of such diseases is crucial for medical professionals to design appropriate treatment strategies, as it directly influences clinical decision-making processes and the selection of effective intervention techniques.
10) Filling (Filled):
Filling refers to the process of deploying coils into an aneurysm to achieve occlusion during endovascular treatment. It highlights the importance of achieving optimal packing density within the aneurysm, which is vital for ensuring stability and preventing re-bleeding, thereby contributing to the overall success of the procedure.
11) Blood:
Blood pertains to the fluid that circulates in the vascular system, playing a critical role in the context of aneurysms and stenting procedures. Understanding blood flow dynamics is essential as it influences aneurysm formation, growth, and the effectiveness of treatments like stenting and coil embolization, ultimately impacting patient outcomes.
12) Silk:
Silk refers to a specific type of flow diverter device utilized for the endovascular reconstruction of cerebral aneurysms. Its relevance lies in its ability to manage blood flow and promote aneurysm thrombosis, marking advancements in the treatment landscape and offering insights into the evolution of endovascular technologies.
13) Pose:
Pose refers to the potential complications that can arise from treatment interventions. Understanding the risks posed by endovascular techniques, such as stent or coil placement, is vital for practitioners to weigh against the therapeutic benefits, guiding their decision-making and fostering safer patient care protocols.
14) Ishat (Isat, Ishad, Isad):
Isat refers to the International Subarachnoid Aneurysm Trial, a landmark study comparing surgical clipping with endovascular coiling for ruptured intracranial aneurysms. Its findings have significantly shaped current clinical practices and outcomes, emphasizing the importance of such studies in understanding treatment efficacy and developing guidelines in neurosurgery.
15) Coma:
Coma indicates a state of prolonged unconsciousness, which may occur due to severe neurological events like subarachnoid hemorrhage. In the clinical context of the article, it highlights the seriousness of conditions treated and the potential impact of interventions, as seen in the presented case of a patient who experienced a loss of consciousness.
Other Science Concepts:
Discover the significance of concepts within the article: ‘Y-Stent-Assisted Coil Embolisation of Wide-Necked Aneurysms: Cases’. Further sources in the context of Science might help you critically compare this page with similair documents:
Blood flow, Therapeutic approach, Patient management, Thrombosis, Neurosurgery, Ischemic Heart Disease, Computed tomography scan, Arterial occlusion, Intensive care unit, Treatment method, Glasgow Coma Scale, In vitro evaluation, Monotherapy, General anaesthesia, Antiplatelet therapy, Thromboembolic complications, Patient Outcome, Dual antiplatelet therapy, CT angiography, Subarachnoid haemorrhage, Complication rate, Computed tomography (CT) scan, Intracranial aneurysm, Cerebral aneurysm, Endovascular treatment, Follow-up visit, Packing density, Vascular malformations, Stent, Blood vessel, Thrombosis risk.
Concepts being referred in other categories, contexts and sources.