title: The stent-assisted coil-jailing technique facilitates efficient embolization of tiny cerebral aneurysms.
abstract: OBJECTIVE
  Tiny cerebral aneurysms are difficult to embolize because the aneurysm's sac is too small for a single small coil, and coils within the aneurysm may escape from the confinement of a stent. This study was performed to introduce the stent-assisted coil-jailing technique and to investigate its effect on the coil embolization of tiny intracranial aneurysms.
  
  
  METHODS
  Sixteen patients with tiny intracranial aneurysms treated with the stent-assisted coil-jailing technique between January 2011 and December 2013 were retrospectively reviewed and followed-up.
  
  
  RESULTS
  All aneurysms were successfully treated with the coil-jailing technique, and at the end of embolization, complete occlusion of the aneurysm was achieved in 9 cases (56.3%), incomplete occlusion in 6 (37.5%), and partial occlusion in 1 (6.3%). Intraprocedural complications included acute thrombosis in one case (6.3%) and re-rupture in another (6.3%). Both complications were managed appropriately with no sequela. Follow-up was performed in all patients for 3-24 months (mean, 7.7 months) after embolization. Complete occlusion was sustained in the 9 aneurysms with initial complete occlusion, progressive thrombosis to complete occlusion occurred in the 6 aneurysms with initial near-complete occlusion, and one aneurysm resulted in progressive thrombosis to complete occlusion after initial partial occlusion. No migration of stents or coils occurred at follow-up as compared with their positions immediately after embolization. At follow-up, all patients had recovered with no sequela.
  
  
  CONCLUSIONS
  The stent-assisted coil-jailing technique can be an efficient approach for tiny intracranial aneurysms, even though no definite conclusion regarding its safety can be drawn from the current data.
authors.affiliation: Department of Neurosurgery, Shijiazhuang First Hospital, Hebei Medical University, Shijiazhuang 050011, China.
authors.forename: Cong-Hui
authors.initials: CH
authors.lastname: Li
authors.affiliation: Department of Neurosurgery, Shijiazhuang First Hospital, Hebei Medical University, Shijiazhuang 050011, China.
authors.forename: Xian-Hui
authors.initials: XH
authors.lastname: Su
authors.affiliation: Department of Neurosurgery, Shijiazhuang First Hospital, Hebei Medical University, Shijiazhuang 050011, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, Shijiazhuang First Hospital, Hebei Medical University, Shijiazhuang 050011, China.
authors.forename: Yong-Feng
authors.initials: YF
authors.lastname: Han
authors.affiliation: Department of Neurosurgery, Shijiazhuang First Hospital, Hebei Medical University, Shijiazhuang 050011, China.
authors.forename: Er-Wei
authors.initials: EW
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, Shijiazhuang First Hospital, Hebei Medical University, Shijiazhuang 050011, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Yang
authors.affiliation: Department of Neurosurgery, Shijiazhuang First Hospital, Hebei Medical University, Shijiazhuang 050011, China.
authors.forename: Dong-Liang
authors.initials: DL
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, Shijiazhuang First Hospital, Hebei Medical University, Shijiazhuang 050011, China.
authors.forename: Song-Tao
authors.initials: ST
authors.lastname: Yang
authors.affiliation: Department of Neurosurgery, Shijiazhuang First Hospital, Hebei Medical University, Shijiazhuang 050011, China.
authors.forename: Zhen-Quan
authors.initials: ZQ
authors.lastname: Yan
authors.affiliation: Department of Neurosurgery, Shijiazhuang First Hospital, Hebei Medical University, Shijiazhuang 050011, China.
authors.forename: Bu-Lang
authors.initials: BL
authors.lastname: Gao
mesh_terms: D000328:Adult; D000368:Aged; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic / Q000295:instrumentation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000473:pathology / Q000628:therapy*; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015607:Stents; D016896:Treatment Outcome
keywords: Coil migration; Redundant coil tails; Stent-assisted coiling; Tiny intracranial aneurysm