Turkish Neurosurgery 2014 , Vol 24 , Num 4
Retreatment of Recanalized Aneurysms After Y-stent-assisted Coil Embolization with Double Enterprise Stents: Case Report and Systematic Review of the Literature
Kenichi KONO, Aki SHINTANI, Tomoaki TERADA
Wakayama Rosai Hospital, Department of Neurosurgery, 93-1 Kinomoto, Wakayama, Japan DOI : 10.5137/1019-5149.JTN.9288-13.0 It is necessary to consider possibility of recanalization and retreatment after coil embolization for cerebral aneurysms. There is concern that retreatment for recanalized aneurysms after Y-stent-assisted coil embolization may be difficult because of double stents, especially in Y-stents with double closed-cell stents owing to narrowed structures. However, no detailed reports of retreatment after Y-stent have been reported. Between July 2010 and June 2013, we treated four aneurysms with Y-stent-assisted coil embolization using Enterprise closed-cell stents. Recanalization occurred in one case (25%), and retreatment was performed. We easily navigated a microcatheter into the target portions of the aneurysm through the Y-stent and occluded the aneurysm with coils. Additionally, by systematically searching in PubMed, we found 105 cases of Y-stent-assisted coil embolization using Enterprise stents or Neuroform stents with more than 6 months of follow-up. Among them, retreatment was performed in 10 cases (9.5%). There were no significant differences in retreatment rates among different stent combinations (P=0.91; Fisher’s exact test). In conclusion, navigation of a microcatheter into the aneurysm through the Y-stent with double Enterprise stents was feasible, and retreatment rates after Y-stent-assisted coiling may not depend on stent combinations. Keywords : Cerebral aneurysms, Enterprise stent, Recanalization, Retreatment, Y-stent-assisted coil embolization
Corresponding author : Kenichi Kono, vyr01450@gmail.com