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Bailout stent deployment during coil embolization of intracranial aneurysms.

Authors
 E. Yoo  ;  D.J. Kim  ;  D.I. Kim  ;  J.-W. Lee  ;  S.H. Suh 
Citation
 AMERICAN JOURNAL OF NEURORADIOLOGY, Vol.30(5) : 1028-1034, 2009 
Journal Title
 AMERICAN JOURNAL OF NEURORADIOLOGY 
ISSN
 0195-6108 
Issue Date
2009
MeSH
Aged ; Blood Vessel Prosthesis* ; Embolization, Therapeutic/instrumentation* ; Embolization, Therapeutic/methods ; Equipment Design ; Equipment Failure ; Feasibility Studies ; Female ; Humans ; Intracranial Aneurysm/therapy* ; Male ; Middle Aged ; Stents* ; Treatment Outcome
Abstract
BACKGROUND AND PURPOSE: Self-expandable stents are an effective tool for coil embolization of wide-neck intracranial aneurysms. The purpose of this study was to assess the feasibility and results of bailout stent positioning during rescue situations after deployment of > or =1 coil. MATERIALS AND METHODS: Among 318 aneurysms treated by coil embolization in 267 patients, 16 patients who were treated by bailout stent deployment were retrospectively reviewed. Bailout procedures were performed to relieve potential parent artery compromise caused by the protruded coil loops or to prevent migration of the unstable coil basket. The size/location of the aneurysm, technical feasibility, successful stabilization rate, and procedure-related complications were evaluated. RESULTS: The locations of the aneurysms were the internal carotid artery (n = 12) and basilar artery (n = 4). The mean aneurysm size was 8.3 mm (range, 3.5-19.4 mm) with hemorrhagic presentation in 3 patients. Relief/prevention of parent artery compromise was achieved by molding the encroached loops back into the sac (n = 11), scaffolding the aneurysmal neck in cases with an unstable coil basket (n = 4), and sidetacking the migrated loop to the parent vessel wall (n = 1). The procedure was technically successful in 87.5% (n = 14). Satisfactory molding or stabilization of the coil was seen in 75% (n = 12). Unsatisfactory molding of the protruded small coil loop was noted in 2 cases of small aneurysms. Acute in-stent thrombosis was successfully managed by thrombolysis (n = 1). CONCLUSIONS: Bailout self-expandable stent deployment may be a feasible and effective method for relief/prevention of parent artery compromise or coil migration caused by prolapsed or unstable coil loops during embolization of aneurysms
Files in This Item:
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DOI
10.3174/ajnr.A1482
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Ik(김동익)
Kim, Dong Joon(김동준) ORCID logo https://orcid.org/0000-0002-7035-087X
Suh, Sang Hyun(서상현) ORCID logo https://orcid.org/0000-0002-7098-4901
Yoo, Eun Hye(유은혜)
Lee, Jae Whan(이재환)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/103880
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