title: A multicenter study of stent-assisted coiling of cerebral aneurysms with a Y configuration.
abstract: BACKGROUND
  Stent-assisted coiling with 2 stents in a Y configuration is a technique for coiling complex wide-neck bifurcation aneurysms.
  
  
  OBJECTIVE
  We sought to provide long-term clinical and angiographic outcomes with Y-stent coiling, which are not currently established.
  
  
  METHODS
  Seven centers provided deidentified, retrospective data on all consecutive patients who underwent stent-assisted coiling for an intracranial aneurysm with a Y-stent configuration.
  
  
  RESULTS
  Forty-five patients underwent treatment by Y-stent coiling. Their mean age was 57.9 years. Most aneurysms were basilar apex (87%), and 89% of aneurysms were unruptured. Mean size was 9.9 mm. Most aneurysms were treated with 1 open-cell and 1 closed-cell stent (51%), with 29% treated with open-open stents and 16% treated with 2 closed-cell stents. Initial aneurysm occlusion was excellent (84% in Raymond grade I or II). Procedural complications occurred in 11% of patients. Mean clinical follow-up was 7.8 months, and 93% of patients had a modified Rankin Scale score of 0 to 2 at last follow-up. Mean angiographic follow-up was 9.8 months, and 92% of patients had Raymond grade I or II occlusion on follow-up imaging. Of those patients with initial Raymond grade III occlusion and follow-up imaging, all but 1 patient progressed to a better occlusion grade (83%; P < .05). Three aneurysms required retreatment because of recanalization (10%). There was no difference in initial or follow-up angiographic occlusion, clinical outcomes, incidence of aneurysm retreatment, or in-stent stenosis among open-open, open-closed, or closed-closed stent groups.
  
  
  CONCLUSIONS
  In a large multicenter series of Y-stent coiling for bifurcation aneurysms, there were low complication rates and excellent clinical and angiographic outcomes.
authors.affiliation: Department of Neurosurgery, University of Florida, Gainesville, Florida, USA. kyle.fargen@neurosurgery.ufl.edu
authors.forename: Kyle M
authors.initials: KM
authors.lastname: Fargen
authors.forename: J
authors.initials: J
authors.lastname: Mocco
authors.forename: Dan
authors.initials: D
authors.lastname: Neal
authors.forename: Michael C
authors.initials: MC
authors.lastname: Dewan
authors.forename: John
authors.initials: J
authors.lastname: Reavey-Cantwell
authors.forename: Henry H
authors.initials: HH
authors.lastname: Woo
authors.forename: David J
authors.initials: DJ
authors.lastname: Fiorella
authors.forename: Maxim
authors.initials: M
authors.lastname: Mokin
authors.forename: Adnan H
authors.initials: AH
authors.lastname: Siddiqui
authors.forename: Aquilla S
authors.initials: AS
authors.lastname: Turk
authors.forename: Raymond D
authors.initials: RD
authors.lastname: Turner
authors.forename: Imran
authors.initials: I
authors.lastname: Chaudry
authors.forename: M Yashar S
authors.initials: MY
authors.lastname: Kalani
authors.forename: Felipe
authors.initials: F
authors.lastname: Albuquerque
authors.forename: Brian L
authors.initials: BL
authors.lastname: Hoh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants; D012189:Retrospective Studies; D015607:Stents; D015996:Survival Rate; D016896:Treatment Outcome