TY - JOUR
T1 - "Cross-over" technique for horizontal stenting of an internal carotid bifurcation aneurysm using a new self-expandable stent
T2 - Technical case report
AU - Benndorf, Goetz
AU - Klucznik, Richard P.
AU - Meyer, Denise
AU - Strother, Charles M.
AU - Mawad, Michel E.
PY - 2006/2/1
Y1 - 2006/2/1
N2 - OBJECTIVE AND IMPORTANCE: To describe the use of a newly available self-expandable stent in a cross-over approach for treatment of a large, wide-necked carotid termination aneurysm. CLINICAL PRESENTATION: A 58-year-old hypertensive woman presenting with mild headaches underwent computed tomography, which showed a nonruptured aneurysm of the left internal carotid artery. She subsequently underwent cerebral angiography, confirming that the aneurysm was located at the left terminal carotid segment with a wide neck. INTERVENTION: Using a cross-over approach from the contralateral internal carotid artery, a new self-expandable stent was advanced through the anterior communicating artery and placed horizontally across the aneurysm neck. Aneurysm occlusion was performed by subsequent trans-stent catheterization of the aneurysm and coil packing. CONCLUSION: Successful stent placement allowed subtotal coil occlusion of the aneurysm with a good anatomic and clinical result. No complications were encountered. The new self-expandable stent is a highly flexible, low-profile device that can be safely navigated through tortuous intracranial vessels even in a crossover technique. Its radial force and closed cell design is suitable for stent-assisted coiling and may be superior to stents with an open cell design.
AB - OBJECTIVE AND IMPORTANCE: To describe the use of a newly available self-expandable stent in a cross-over approach for treatment of a large, wide-necked carotid termination aneurysm. CLINICAL PRESENTATION: A 58-year-old hypertensive woman presenting with mild headaches underwent computed tomography, which showed a nonruptured aneurysm of the left internal carotid artery. She subsequently underwent cerebral angiography, confirming that the aneurysm was located at the left terminal carotid segment with a wide neck. INTERVENTION: Using a cross-over approach from the contralateral internal carotid artery, a new self-expandable stent was advanced through the anterior communicating artery and placed horizontally across the aneurysm neck. Aneurysm occlusion was performed by subsequent trans-stent catheterization of the aneurysm and coil packing. CONCLUSION: Successful stent placement allowed subtotal coil occlusion of the aneurysm with a good anatomic and clinical result. No complications were encountered. The new self-expandable stent is a highly flexible, low-profile device that can be safely navigated through tortuous intracranial vessels even in a crossover technique. Its radial force and closed cell design is suitable for stent-assisted coiling and may be superior to stents with an open cell design.
KW - Aneurysm
KW - Cross-over
KW - Self-expandable stent
KW - Stent assisted coiling
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U2 - 10.1227/01.NEU.0000193530.95489.D8
DO - 10.1227/01.NEU.0000193530.95489.D8
M3 - Article
C2 - 16462622
AN - SCOPUS:33644624661
VL - 58
JO - Neurosurgery.
JF - Neurosurgery.
SN - 0148-396X
IS - SUPPL. 1
ER -