title: "Y" and "X" stent-assisted coiling of complex and wide-neck intracranial bifurcation aneurysms.
abstract: OBJECTIVE
  Stent-assisted coiling with two stents has been described in some series for the treatment of complex and wide-neck bifurcation aneurysms. Our aim was to report our experience of a stent-assisted coiling technique with double stents in "Y" and "X" configurations, with emphasis on safety, feasibility, and efficacy.
  
  
  METHODS
  Clinical and angiographic outcomes of patients for whom the strategic therapeutic option was the stent-assisted coiling technique in a Y or X configuration for neck scaffolding from June 2006 to June 2013 were retrospectively analyzed.
  
  
  RESULTS
  One hundred five aneurysms in 97 patients were treated during 100 consecutive procedures. There were 54.2% (57/105) MCA, 28.6% (30/105) anterior communicating artery, 16.2% (17/105) basilar tip, and 1.0% (1/105) ICA termination aneurysms. A Y stent placement was used to treat 87 aneurysms in 85 procedures; an X stent placement was used to treat 7 aneurysms in 6 procedures, while 9 procedures failed for 11 aneurysms. There were 10.0% (10/100) procedure-related permanent neurologic deficits and 1.0% (1/100) death. The immediate angiographic controls showed a complete occlusion in 47.6% (50/105) of the aneurysms and a partial (neck or sac remnant) occlusion in 52.4% (55/105). To date, 81.0% (85/105) of the aneurysms have been followed up (mean, 17 months) with angiography, disclosing a recanalization in 5.9% (5/85) and an improvement in 42.4% (36/85). At discharge and follow-up, the mRS score was 0 in 83.5% (81/97) of patients, 1 in 4.1% (4/97), 2 in 3.1% (3/97), 3 in 4.1% (4/97), 4 in 3.1% (3/97), and 6 in 2.1% (2/97).
  
  
  CONCLUSIONS
  Y and X stent-assisted coiling of complex and wide-neck intracranial bifurcation aneurysms is an effective technique.
authors: From the Department of Interventional and Functional Neuroradiology, Foundation Rothschild Hospital, Paris, France. bbartolini@fo-rothschild.fr.
authors: B
authors: B
authors: Bartolini
authors: From the Department of Interventional and Functional Neuroradiology, Foundation Rothschild Hospital, Paris, France.
authors: R
authors: R
authors: Blanc
authors: From the Department of Interventional and Functional Neuroradiology, Foundation Rothschild Hospital, Paris, France.
authors: S
authors: S
authors: Pistocchi
authors: From the Department of Interventional and Functional Neuroradiology, Foundation Rothschild Hospital, Paris, France.
authors: H
authors: H
authors: Redjem
authors: From the Department of Interventional and Functional Neuroradiology, Foundation Rothschild Hospital, Paris, France.
authors: M
authors: M
authors: Piotin
mesh_terms: D000368:Aged; D001807:Blood Vessel Prosthesis; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D055815:Young Adult