Waffle-cone technique with Solitaire™ AB Remodeling Device: endovascular treatment of highly selected complex cerebral aneurysms

Introduction To evaluate patients with complex aneurysms who underwent waffle-cone stent-assisted coil embolization. Methods From February 2008 to February 2010, consecutive data were collected from 80 patients with aneurysms treated with the Solitaire™ AB Remodeling Device followed by a standard co...

Full description

Saved in:
Bibliographic Details
Published in:Neuroradiology 2011-12, Vol.53 (12), p.961-972
Main Authors: Sychra, Vojtech, Klisch, Joachim, Werner, Maren, Dettenborn, Christian, Petrovitch, Alexander, Strasilla, Christoph, Gerlach, Rüdiger, Rosahl, Steffen, Holtmannspötter, Markus
Format: Article
Language:English
Subjects:
Adult
Adult and adolescent clinical studies
Aged
Aneurysm
Aneurysms
Antibodies
Biological and medical sciences
Cardiovascular system
Cerebral blood flow
Coiling
Data processing
Embolization
Endovascular Procedures - instrumentation
Endovascular Procedures - methods
Female
Hospitals
Humans
Hyperplasia
Imaging
Implants
Interventional Neuroradiology
Intracranial Aneurysm - diagnostic imaging
Intracranial Aneurysm - surgery
Investigative techniques, diagnostic techniques (general aspects)
Ischemia
Male
Medical sciences
Medicine
Medicine & Public Health
Middle Aged
Miscellaneous
Mood disorders
Morbidity
Nervous system
Neuroimaging
Neurology
Neuroradiology
Neurosciences
Neurosurgery
Preservation
Prosthesis Design
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Radiodiagnosis. Nmr imagery. Nmr spectrometry
Radiography, Interventional - methods
Radiology
Surgical techniques
Treatment Outcome
Vascular surgery
Vasoconstriction
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Introduction To evaluate patients with complex aneurysms who underwent waffle-cone stent-assisted coil embolization. Methods From February 2008 to February 2010, consecutive data were collected from 80 patients with aneurysms treated with the Solitaire™ AB Remodeling Device followed by a standard coiling procedure using bare or/and bioactive coils. Six of these patients were treated using the “waffle-cone-technique” placing the distal end of a stent directly into the base of a bifurcation aneurysm and coiling through the expanded and cone-shaped distal end of the stent allowing for preservation of parent artery patency. The aneurysms were located at the P3 segment of the posterior cerebral artery ( n  = 1), the middle cerebral artery bifurcation ( n  = 1), the basilar tip ( n  = 2), and the AComAnt ( n  = 2). Four patients underwent follow-up (2–7 months, mean 4.5 months). Results Waffle-cone positioning of the Solitaire™ AB Remodeling Device was obtained in all cases without technical problems. No permanent procedural morbidity was observed. In all patients, a Raymond class 2 occlusion was obtained and five patients left the hospital with a good clinical status (mRS0 n  = 3, mRS1 n  = 1) or no new neurologic deficits (mRS4 n  = 1). One patient with SAH III died due to severe vasospasms. Due to major recanalization during follow-up, retreatment was necessary or is planned in four cases; one asymptomatic intimal hyperplasia was observed 8 weeks after initial treatment. Conclusion The waffle-cone technique may enhance the possibilities of the endovascular treatment of these complex aneurysms. Due to the high rate of recanalization requiring endovascular retreatment, stringent angiographic and clinical follow-up is warranted.
ISSN:0028-3940
1432-1920
DOI:10.1007/s00234-010-0766-6