scholarly journals Treatment of wide-necked cerebral aneurysms with the Neuroform2 Treo stent

2005 ◽  
Vol 18 (2) ◽  
pp. 1-5 ◽  
Author(s):  
Sepehr Sani ◽  
Kirk W. Jobe ◽  
Demetrius K. Lopes
Keyword(s):  
Coil Embolization ◽  
Intracranial Aneurysms ◽  
Cerebral Aneurysms ◽  
Technical Difficulty ◽  
Neurological Complications ◽  
Clinical Effects ◽  
Parent Vessel ◽  
Cerebral Angiogram ◽  
Aneurysm Neck

Object Until recently, wide-necked aneurysms were not considered amenable to treatment with coil embolization. The recent introduction of intracranial stents has provided a method of preventing coil migration out of wide-necked aneurysms. The Neuroform2 Treo is a modification of the Neuroform stent; the new version has a higher metal/artery ratio. The authors' initial experience with the use of this stent in combination with coil embolization to treat wide-necked intracranial aneurysms is reported and technical considerations are discussed. Methods The authors' first 10 consecutive patients with wide-necked intracranial aneurysms were included in this study. Inclusion criteria restricted the group to adult patients with wide-necked intracranial aneurysms (ruptured and unruptured lesions). A wide neck was defined as a dome/neck ratio of less than 2 or a neck that was 4 mm or wider as measured on angiograms. Immediate postprocedure angiography studies were performed to determine successful coil occlusion of the aneurysm as well as patency of the parent vessel. Six-month follow-up angiograms were obtained in all patients. Ten aneurysms with poor dome/neck ratios (< 2) were studied in 10 patients. In all cases the stent was delivered to the aneurysm site and positioned without difficulty. No branch artery compromise was observed. A technical difficulty occurred in one case, with prolapse of a coil into the parent vessel, which was successfully corrected with no adverse clinical effects. There were no clinical or neurological complications associated with endovascular treatment of aneurysms in this series. One patient required further coil embolization because of findings on the 6-month follow-up cerebral angiogram. Conclusions The Neuroform2 Treo navigates similarly to the Neuroform2, with the advantage of increased aneurysm neck coverage. This feature may lower the retreatment rates for wide-necked cerebral aneurysms.

Recent Steps Toward A Reconstructive Endovascular Solution for the Orphaned, Complex-Neck Aneurysm

Neurosurgery ◽  
2006 ◽  
Vol 59 (suppl_5) ◽  
pp. S3-77-S3-92 ◽  
Author(s):  
Peter K. Nelson ◽  
Daniel Sahlein ◽  
Maksim Shapiro ◽  
Tibor Becske ◽  
Brian-Fred Fitzsimmons ◽  
...  
Keyword(s):  
Coil Embolization ◽  
Cerebral Aneurysms ◽  
Visual Outcome ◽  
Neurological Complications ◽  
Anatomic Reconstruction ◽  
Parent Artery ◽  
Medium Term ◽  
Aneurysm Neck ◽  
Poor Visual Outcome

Abstract OBJECTIVE: The purposes of this article are to summarize recent developments and concerns in endovascular aneurysm therapy leading to the adjunctive use of endoluminal devices, to review the published literature on stent-supported coil embolization of cerebral aneurysms, and to describe our experience with this technique in a limited subgroup of problematic complex aneurysms over a medium-term follow-up period. METHODS: Between January 2003 and June 2004, 28 individuals among 157 patients with cerebral aneurysms we evaluated were identified as harboring aneurysms with exceptionally broad necks. Out of these 28 patients, 16 were treated with a combination of stents and detachable coils, preserving the parent artery. Recorded data included patient demographics, the clinical presentation, aneurysm location and characteristics, procedural details, and clinical and angiographic outcome. RESULTS: Over an 18-month period, 16 patients with large cerebral aneurysms additionally characterized by neck sizes between 7 and 14 mm were treated, using combined coil embolization of the aneurysm with stent reconstruction of the aneurysm neck. Thirteen out of the 16 aneurysms were occluded at angiographic reevaluation between 11 and 24 months (mean angiographic follow-up, 17.5 mo). There were no treatment-related deaths or clinically evident neurological complications. Thirteen patients experienced excellent clinical outcomes, with good outcomes in two patients and a poor visual outcome in one patient (mean clinical follow-up, 29 mo). A single technical complication occurred, involving transient nonocclusive stent-associated thrombus, which was treated uneventfully with abciximab. CONCLUSION: Stent-supported coil embolization of large, complex-neck cerebral aneurysms seems to provide superior medium-term anatomic reconstruction of the parent artery compared with historic series of aneurysms treated exclusively with endosaccular coils. In the near future, increasingly sophisticated endoluminal devices offering higher coverage of the neck defect will likely enable more definitive endovascular treatment of complex cerebral aneurysms and further expand our ability to manipulate the vascular biology of the parent artery.

A novel endovascular clip system for the treatment of intracranial aneurysms: technology, concept, and initial experimental results

2008 ◽  
Vol 108 (6) ◽  
pp. 1230-1240 ◽  
Author(s):  
Thomas R. Marotta ◽  
Thorsteinn Gunnarsson ◽  
Ian Penn ◽  
Donald R. Ricci ◽  
Ian Mcdougall ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Delivery System ◽  
Intracranial Aneurysms ◽  
Balloon Catheter ◽  
Cerebral Aneurysms ◽  
Histopathological Analysis ◽  
Parent Vessel ◽  
Flow Models ◽  
Aneurysm Neck ◽  
Novel Device

Object The authors describe a novel device for the endovascular treatment of intracranial aneurysms, the endovascular clip system (eCLIPs). Descriptions of the device and its delivery system as well as the results of flow model tests and the treatment of experimental aneurysms are provided. Methods The eCLIPs comprises a flexible hybrid implantable device (an anchor and a covered leaf) and a balloon catheter delivery system, designed to be positioned and activated in the parent vessel in such a way that the covered portion will abut the aneurysm neck. The eCLIPs was subjected to testing in glass, elastomeric, and cadaveric flow models to determine its navigability, orientation, and activation compared with commercially available stents. In a second experiment, 8 carotid artery sidewall aneurysms in swine were treated using eCLIPs. The degree of occlusion was observed on angiography immediately following and 30 days after device activation, and a histological analysis was performed at 30 days. Results The device could navigate tortuous glass models and human cadaveric vessels. Compared with commercially available stents, the eCLIPs performed well. It could be navigated, oriented, and activated easily and reliably. With regard to the 8 porcine experimental aneurysms, immediate postactivation angiograms confirmed complete occlusion of 4 lesions and near occlusion of the other 4. Angiographic follow-up at 30 days postactivation showed occlusion of all 8 aneurysms and patency of all parent vessels. Histopathological analysis revealed aneurysm healing, with smooth-muscle cells growing across the lesion neck to allow reendothelialization. Conclusions Aneurysm occlusion with a single extrasaccular endovascular device has potential advantages. The authors believe that eCLIPs may prove to be a useful tool in the endovascular treatment of cerebral aneurysms. The system should reduce risks associated with coiling, procedure time, costs, and radiation exposure. The device satisfactorily occluded 8 experimental sidewall aneurysms. The observed healing pattern is similar to that seen after microsurgical clipping.

LVIS Blue as a low porosity stent and coil adjuvant

2018 ◽  
Vol 10 (7) ◽  
pp. 682-686 ◽  
Author(s):  
Matthew J Koch ◽  
Christopher J Stapleton ◽  
Scott B Raymond ◽  
Susan Williams ◽  
Thabele M Leslie-Mazwi ◽  
...  
Keyword(s):  
Coil Embolization ◽  
Intracranial Aneurysms ◽  
Posterior Inferior Cerebellar Artery ◽  
Endovascular Embolization ◽  
Superior Cerebellar Artery ◽  
Anterior Communicating Artery ◽  
Aneurysm Neck ◽  
Proximal Internal Carotid Artery ◽  
Cerebellar Artery

IntroductionThe LVIS Blue is an FDA-approved stent with 28% metallic coverage that is indicated for use in conjunction with coil embolization for the treatment of intracranial aneurysms. Given a porosity similar to approved flow diverters and higher than currently available intracranial stents, we sought to evaluate the effectiveness of this device for the treatment of intracranial aneurysms.MethodsWe performed an observational single-center study to evaluate initial occlusion and occlusion at 6-month follow-up for patients treated with the LVIS Blue in conjunction with coil embolization at our institution using the modified Raymond–Roy classification (mRRC), where mRRC 1 indicates complete embolization, mRRC 2 persistent opacification of the aneurysm neck, mRRC 3a filling of the aneurysm dome within coil interstices, and mRRC 3b filling of the aneurysm dome.ResultsSixteen aneurysms were treated with the LVIS Blue device in conjunction with coil embolization with 6-month angiographic follow-up. Aneurysms were treated throughout the intracranial circulation: five proximal internal carotid artery (ICA) (ophthalmic or communicating segments), two superior cerebellar artery, two ICA terminus, two anterior communicating artery, two distal middle cerebral artery, one posterior inferior cerebellar artery, and two basilar tip aneurysms. Post-procedurally, there was one mRRC 1 closure, five mRRC 2 closures, and 10 mRRC 3a or 3b occlusion. At follow-up, all the mRRC 1 and mRRC 3a closures, 85% of the mRRC 3b closures and 75% of the mRRC 2 closures were stable or improved to an mRRC 1 or 2 at follow-up.ConclusionsThe LVIS Blue represents a safe option as a coil adjunct for endovascular embolization within both the proximal and distal anterior and posterior circulation.

scholarly journals “Waffle Cone” Technique for Intra/Extra-Aneurysmal Stent Placement for the Treatment of Complex and Wide-Necked Bifurcation Aneurysm

2008 ◽  
Vol 14 (2_suppl) ◽  
pp. 49-52 ◽  
Author(s):  
Tzu-Hsien Yang ◽  
Ho-Fai Wong ◽  
Ming-Shiang Yang ◽  
Chang-Hsien Ou ◽  
Tzu-Lung Ho
Keyword(s):  
Endovascular Treatment ◽  
Stent Placement ◽  
Coil Embolization ◽  
Intracranial Aneurysms ◽  
Three Dimensional ◽  
Parent Vessel ◽  
Surgical Clipping ◽  
Selective Embolization ◽  
Bifurcation Aneurysm

Endovascular treatment of intracranial aneurysms by coiling has become an accepted alternative to surgical clipping 1. In cases of wide-necked and sidewall aneurysms, selective embolization is difficult because of the risk of coil protrusion into the parent vessel. The use of three-dimensional coils, stents 2, and balloon remodeling have all aided the attempt to adequately manage such lesions. However, compared with sidewall aneurysms, bifurcation aneurysms are more challenging from an endovascular standpoint. Because of their specific anatomy and hemodynamics, the tendency to recur and rerupture is higher. Several authors have reported successful treatment of these complex and wide-necked bifurcation aneurysms by using Y-configured dual stent-assisted coil embolization 3,4, the double microcatheter technique 5, a more compliant balloon remodeling technique6, the TriSpan neck-bridge device7, or the waffle cone technique8. We describe two cases of wide-necked bifurcation aneurysms in which the waffle cone technique was used for coil embolization. The waffle cone technique was first described in 2006; however, the small number of published cases and the lack of follow-up prevent one from assessing this technique's durability and the probability of recanalization. We report the cases of two patients harboring unruptured wide-necked bifurcation aneurysms that were treated and followed-up for six months.

Surgically Treated Aneurysms Previously Coiled: Lessons Learned

Neurosurgery ◽  
2004 ◽  
Vol 54 (2) ◽  
pp. 300-305 ◽  
Author(s):  
Erol Veznedaroglu ◽  
Ronald P. Benitez ◽  
Robert H. Rosenwasser
Keyword(s):  
Coil Embolization ◽  
Patient Population ◽  
Cerebral Aneurysms ◽  
Lessons Learned ◽  
Anterior Communicating Artery ◽  
Unique Problem ◽  
Aneurysm Neck ◽  
Cerebellar Artery ◽  
Patient Groups

Abstract OBJECTIVE Intravascular coil embolization of cerebral aneurysms has proved to be a safe and effective treatment in certain patient groups; however, this treatment is relatively new, and the long-term outcomes are unknown. One of the known complications is refilling of the aneurysm dome, which is seen in follow-up studies. This patient population poses unique technical difficulties for the neurosurgeon. We present a series of 18 patients who underwent surgery for residual aneurysms after coil remobilization. METHODS During a 5-year period, we performed surgery in 18 patients who had previously undergone coil embolization for their aneurysms. Of these aneurysms, four were in the anterior communicating artery, five were in the posterior communicating artery, three were in the internal carotid artery, three were in the posteroinferior cerebellar artery, and three were in the middle cerebral artery. One patient presented with rupture, one presented with acute IIIrd cranial nerve palsy, and the rest of the aneurysms were found on routine follow-up angiograms. Fifteen aneurysms were clipped, and in three patients, they were wrapped because the clip could not be placed adequately. RESULTS There were no major complications in any of the patients, and all had uneventful recoveries. The presence of coils in the aneurysm dome and/or neck made clipping and exposure of the aneurysm neck difficult, resulting in incomplete neck obliteration in three patients. CONCLUSION Operative clipping after previous coil embolization in aneurysms poses a unique problem for neurosurgeons. With the increasing use of coil embolization, this patient population will undoubtedly increase. The neurosurgeon should be aware of the difficulties and pitfalls encountered in these patients.

scholarly journals Optical coherence tomography: a new method to assess aneurysm healing

2005 ◽  
Vol 102 (2) ◽  
pp. 348-354 ◽  
Author(s):  
William E. Thorell ◽  
Michael M. Chow ◽  
Richard A. Prayson ◽  
Mark A. Shure ◽  
Sung W. Jeon ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Coil Embolization ◽  
Imaging Modality ◽  
Cerebral Aneurysms ◽  
Biological Tissues ◽  
Optical Coherence ◽  
Content Type ◽  
Aneurysm Neck ◽  
Fine Print

Object. Aneurysmal subarachnoid hemorrhage affects approximately 10/100,000 people per year. Endovascular coil embolization is used increasingly to treat cerebral aneurysms and its safety and durability is rapidly developing. The long-term durability of coil embolization of cerebral aneurysms remains in question; patients treated using this modality require multiple follow-up angiography studies and occasional repeated treatments. Methods. Optical coherence tomography (OCT) is an emerging imaging modality that uses backscattered light to produce high-resolution tomography of optically accessible biological tissues such as the eye, luminal surface of blood vessels, and gastrointestinal tract. Vascular OCT probes in the form of imaging microwires are presently available—although not Food and Drug Administration—approved—and may be adapted for use in the cerebral circulation. In this study the authors describe the initial use of OCT to make visible the neck of aneurysms created in a canine model and treated with coil embolization. Optical coherence tomography images demonstrate changes that correlate with the histological findings of healing at the aneurysm neck and thus may be capable of demonstrating human cerebral aneurysm healing. Conclusions. Optical coherence tomography may obviate the need for subsequent follow-up angiography studies as well as aid in the understanding of endovascular tissue healing. Data in this study demonstrate that further investigation of in vivo imaging with such probes is warranted.

Early postmarket results with PulseRider for treatment of wide-necked intracranial aneurysms: a multicenter experience

2020 ◽  
Vol 133 (6) ◽  
pp. 1756-1765 ◽  
Author(s):  
Visish M. Srinivasan ◽  
Aditya Srivatsan ◽  
Alejandro M. Spiotta ◽  
Benjamin K. Hendricks ◽  
Andrew F. Ducruet ◽  
...  
Keyword(s):  
Cerebral Artery ◽  
Intracranial Aneurysms ◽  
Aneurysm Rupture ◽  
Anterior Communicating Artery ◽  
Parent Vessel ◽  
Aneurysm Neck ◽  
Off Label ◽  
Fda Approval ◽  
Class 1

OBJECTIVETraditionally, stent-assisted coiling and balloon remodeling have been the primary endovascular treatments for wide-necked intracranial aneurysms with complex morphologies. PulseRider is an aneurysm neck reconstruction device that provides parent vessel protection for aneurysm coiling. The objective of this study was to report early postmarket results with the PulseRider device.METHODSThis study was a prospective registry of patients treated with PulseRider at 13 American neurointerventional centers following FDA approval of this device. Data collected included clinical presentation, aneurysm characteristics, treatment details, and perioperative events. Follow-up data included degree of aneurysm occlusion and delayed (> 30 days after the procedure) complications.RESULTSA total of 54 aneurysms were treated, with the same number of PulseRider devices, across 13 centers. Fourteen cases were in off-label locations (7 anterior communicating artery, 6 middle cerebral artery, and 1 A1 segment anterior cerebral artery aneurysms). The average dome/neck ratio was 1.2. Technical success was achieved in 52 cases (96.2%). Major complications included the following: 3 procedure-related posterior cerebral artery strokes, a device-related intraoperative aneurysm rupture, and a delayed device thrombosis. Immediately postoperative Raymond-Roy occlusion classification (RROC) class 1 was achieved in 21 cases (40.3%), class 2 in 15 (28.8%), and class 3 in 16 cases (30.7%). Additional devices were used in 3 aneurysms. For those patients with 3- or 6-month angiographic follow-up (28 patients), 18 aneurysms (64.2%) were RROC class 1 and 8 (28.5%) were RROC class 2.CONCLUSIONSPulseRider is being used in both on- and off-label cases following FDA approval. The clinical and radiographic outcomes are comparable in real-world experience to the outcomes observed in earlier studies. Further experience is needed with the device to determine its role in the neurointerventionalist’s armamentarium, especially with regard to its off-label use.

Intravascular stents for intracranial internal carotid and vertebral artery aneurysms: preliminary clinical experience

1998 ◽  
Vol 5 (4) ◽  
pp. E5 ◽  
Author(s):  
Giuseppe Lanzino ◽  
Ajay K. Wakhloo ◽  
Richard D. Fessler ◽  
Robert A. Mericle ◽  
Lee R. Guterman ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Stent Placement ◽  
Intracranial Aneurysms ◽  
Internal Carotid ◽  
Posterior Inferior Cerebellar Artery ◽  
Parent Artery ◽  
High Porosity ◽  
Parent Vessel ◽  
Aneurysm Neck

Results of previous in vitro and in vivo experimental studies have suggested that the placement of a porous stent within the parent artery across the aneurysm neck may hemodynamically uncouple the aneurysm from the parent vessel, leading to thrombosis of the aneurysm. For complex wide-necked aneurysms, a stent may also aid the packing of the aneurysm with Guglielmi detachable coils (GDCs) by acting as a rigid scaffold that prevents coil herniation into the parent vessel. Recently, improved stent system delivery technology has allowed access to the tortuous vascular segments of the intracranial system. The authors report here the intracranial stenting of aneurysms involving different segments of the internal carotid artery (ICA) and the vertebral artery (VA). Four patients with intracranial aneurysms located at the petrous, cavernous, and paraclinoid segments of the ICA and at the VA proximal to the origin of the posterior inferior cerebellar artery, respectively, were treated since January 1998. In three of these patients, stent placement across the aneurysm neck was followed by GDC placement, accomplished via a microcatheter through stent mesh. In one patient, the aneurysm was treated solely by stenting. No periprocedural complications were observed, and at follow up, no patient was found to have suffered symptoms referable to aneurysm growth or thromboembolic complications. More than 90% occlusion of the aneurysm was achieved in the three cases treated by stenting and GDC placement. One of these patients underwent 6-month follow-up angiography that did not reveal any in-stent stenosis. In the case treated solely by stent placement, no evidence of aneurysm thrombosis was observed either immediately postprocedure or on follow-up angiography performed 24 hours later. A new generation of flexible stents can be used to treat intracranial aneurysms in difficult-to-access areas such as the proximal intracranial segments of the ICA or the VA. The stent allows tight coil packing even in the presence of a wide-necked, irregularly shaped aneurysm and may provide an endoluminal matrix for endothelial growth. Although convincing experimental evidence suggests that stent placement across the aneurysm neck may by itself promote intraluminal thrombosis, the role of this phenomenon in clinical practice may be limited at present by the high porosity of currently available stents.

Usefulness of the Neuroform Stent for the Treatment of Cerebral Aneurysms: Results at Initial (3–6-mo) Follow-up

Neurosurgery ◽  
2005 ◽  
Vol 56 (6) ◽  
pp. 1191-1202 ◽  
Author(s):  
David Fiorella ◽  
Felipe C. Albuquerque ◽  
Vivek R. Deshmukh ◽  
Cameron G. McDougall
Keyword(s):  
Present Report ◽  
Artery Bypass ◽  
Superficial Temporal Artery ◽  
Cerebral Aneurysms ◽  
Parent Vessel ◽  
Technical Problems ◽  
Aneurysm Neck ◽  
Aneurysm Size ◽  
Neuroform Stent

Abstract OBJECTIVE: The Neuroform microstent, a flexible, self-expanding, nitinol stent specifically designed for use in the cerebral vasculature, became available in North America for aneurysm treatment in November 2002. The present report details our experience with the Neuroform stent over the past 2 years, with an emphasis on evolving treatment strategies and treatment durability at initial (3–6 mo) follow-up. METHODS: All patients included in this report were registered in a prospectively maintained database. We assessed the clinical history, indications for stent use, aneurysm dimensions, technical details of the procedures, degree of aneurysm occlusion, angiographic and clinical findings at follow-up, and complications. RESULTS: Over a 20-month period, 64 patients with 74 aneurysms were treated with 86 Neuroform stents. Of 64 patients, 16 (25%) were treated in the context of subarachnoid hemorrhage (8 acute, 7 subacute, 1 remote). Indications for stent use included broad aneurysm neck (n = 51 stents; average neck, 5.1 mm; aneurysm size, 8.2 mm), fusiform/dissecting morphology (n = 17), salvage/bailout for coils prolapsed into the parent vessel (n = 7), and giant aneurysm (n = 11). Sixty-one aneurysms were stented and coiled with complete or near complete (&gt;95%) occlusion in 28 patients (45.9%) and partial occlusion (&lt;95%) in 33 patients (54%). Follow-up angiographic (n = 43) or magnetic resonance angiographic (n = 5) data (average follow-up, 4.6 mo; median, 4 mo; range, 1.5–13 mo) for 48 aneurysms (46 patients) after stent-supported coil embolization demonstrated progressive thrombosis in 25 patients (52%), recanalization in 11 patients (23%) (8 of whom were retreated), and no change in 12 patients (25%). Follow-up angiography in 5 additional patients with dissecting aneurysms treated with stents alone demonstrated interval vascular remodeling with decreased aneurysm size in all patients. Delayed, severe, in-stent stenosis was observed in 3 patients, 1 of whom was symptomatic and required angioplasty and subsequently superficial temporal artery-to-middle cerebral artery bypass surgery. Using the second-generation Neuroform2 delivery system (n = 53), very few technical problems with stent delivery and deployment have been encountered (n = 2). CONCLUSION: The Neuroform stent facilitates adequate embolization of complex cerebral aneurysms, which would not otherwise be amenable to endovascular therapy. Initial follow-up data indicate favorable progressive thrombosis and recanalization rates for aneurysms after Neuroform stent-assisted embolization. These advantages of stenting were most evident for small aneurysms with wide necks.

scholarly journals Y-Stent-Assisted Coil Embolization of Wide-Neck Intracranial Aneurysms

2011 ◽  
Vol 17 (1) ◽  
pp. 36-48 ◽  
Author(s):  
E. Akgul ◽  
E. Aksungur ◽  
T. Balli ◽  
B. Onan ◽  
D.M. Yilmaz ◽  
...  
Keyword(s):  
Coil Embolization ◽  
Intracranial Aneurysms ◽  
Neurological Complications ◽  
Anterior Communicating Artery ◽  
Hybrid Technique ◽  
Treatment Technique ◽  
Midterm Results ◽  
Procedural Complication ◽  
Wide Neck

This report evaluated the short and midterm results of the safety and effectiveness of the treatment technique with hybrid and non-hybrid Y-configured, dual stent-assisted coil embolization of wide-neck intracranial aneurysms, and reviewed the literature concerning this technique. Nine patients, eight with unruptured and one with ruptured aneurysms were included in the study. Of aneurysms embolized with a hybrid (with two different stents) and non-hybrid (with two identical stents) technique, three were located in the anterior communicating artery, three at the tip and one at the distal site of basilar artery, and two in the middle cerebral artery. All aneurysms included the orifices of bifurcation vessels. All aneurysms were stented and embolized during the same session. While Neuroform and Enterprise stents were used in the hybrid technique, two Enterprise stents were used in the non-hybrid technique. Dual Y-stent assisted coil embolization was performed successfully in eight of nine patients (88.9%), including five patients (55.6%) with hybrid and three patients (33.3%) with non-hybrid technique. No procedural complication, no mortality and no minor or major neurological complications were seen during the angiographic or clinical follow-up. When an attempt was made at passing the second stent through the first Enterprise stent, the stent protruded inside the aneurysm in one patient (11.1%). Hybrid or non-hybrid dual Y-stent-assisted coil embolization in the treatment of ruptured or unruptured wide-neck and complex intracranial aneurysms is a safe and effective method from the viewpoint of short and midterm results.

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