title: Pericallosal artery aneurysm treatment using Y-configuration stent-assisted coil embolization: a report of four cases.
abstract: BACKGROUND
  Pericallosal artery aneurysms at the bifurcation represent a special endovascular technical challenge given their distal location, commonly wide-neck morphology, small parent vessel diameter and potentially high recurrence rate after coiling given the bifurcation location. Y-configuration stent-assisted coil embolization techniques have been reported for the treatment of wide-neck aneurysms located at other vascular bifurcations and only rarely with A2 bifurcation aneurysms.
  
  
  METHODS
  A neurointerventional database was reviewed for identification of all cases of A2 bifurcation aneurysms that were treated with Y-stent configuration. The authors report clinical, technical and outcome data on four patients with pericallosal aneurysms who were treated with a Y-configuration stent-assisted coil embolization technique.
  
  
  RESULTS
  A Y-configuration stent placement in the anterior cerebral artery/A2 bifurcation was successfully achieved in all four patients without significant technical difficulties. One patient presented with a previously ruptured and partially treated aneurysm and three patients with incidentally found aneurysms. All four patients had a Y-configuration stent placement in one setting. The Y-configuration allowed for complete occlusion of all four aneurysms with no recurrence or arterial occlusion on mean angiographic follow-up of 13.5 months (6-28).
  
  
  CONCLUSIONS
  Treating wide-neck pericallosal artery aneurysms at the bifurcation with Y-configuration stent placement is feasible and effective. This technique may be considered as a therapeutic option for wide-neck aneurysms that pose a difficult technical challenge.
authors.affiliation: Department of Neurology, Neurosurgery and Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin 53226, USA.
authors.forename: Ziad M
authors.initials: ZM
authors.lastname: Darkhabani
authors.forename: Marc A
authors.initials: MA
authors.lastname: Lazzaro
authors.forename: Osama O
authors.initials: OO
authors.lastname: Zaidat
mesh_terms: D001807:Blood Vessel Prosthesis; D004621:Embolization, Therapeutic / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome