title: Y-stent assisted coiling of bifurcation aneurysms with Enterprise stent: long-term follow-up.
abstract: BACKGROUND
  Y-stent assisted coiling has been proposed for the treatment of wide-neck bifurcation aneurysms, but there are many technical variations. We report our single-center experience of Y-stent assisted coiling of bifurcation aneurysms with the closed cell Enterprise stent in order to evaluate the safety and long-term results of this technique. The literature on Y-stenting and its hemodynamic effects are reviewed.
  
  
  METHODS
  Fifty-two consecutive patients with wide-neck bifurcation aneurysms underwent Y-stent assisted coiling with two Enterprise stents. The procedure was completed in 48 cases (92.3%) and technical failure occurred in 4 cases (7.3%). Cases performed with other stents were excluded. All procedures were performed under double antiplatelet therapy. Periodic clinical and neuroradiological follow-up was performed.
  
  
  RESULTS
  Mean neuroradiological follow-up time was 26 months. Complete immediate occlusion was obtained in 87.5% of patients. Two remnants had regrown at follow-up and were recoiled, achieving complete occlusion. The late neuroradiological occlusion rate was: complete occlusion 93.6%, neck remnant 4.3%, sac remnant 2.1%. No in-stent stenosis was detected at follow-up. Among the 48 procedures, two complications occurred (4.2%). Mortality was 2.1%. No delayed ischemic stroke occurred.
  
  
  CONCLUSIONS
  Y-stent assisted coiling has a high immediate occlusion rate and very good long-term stability. The procedure is relatively safe, although the complication and mortality rates are not negligible. Two Enterprise stents can be safely used for Y-stenting and, indeed, offer the advantage of easier catheterization, delivery and deployment into distal and tortuous vessels than open cell stents.
authors.affiliation: Interventional Neuroradiology Unit, Careggi University Hospital, Florence, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Limbucci
authors.affiliation: Interventional Neuroradiology Unit, Careggi University Hospital, Florence, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Renieri
authors.affiliation: Interventional Neuroradiology Unit, Careggi University Hospital, Florence, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Nappini
authors.affiliation: Interventional Neuroradiology Unit, Careggi University Hospital, Florence, Italy.
authors.forename: Arturo
authors.initials: A
authors.lastname: Consoli
authors.affiliation: Interventional Neuroradiology Unit, Careggi University Hospital, Florence, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Rosi
authors.affiliation: Interventional Neuroradiology Unit, Careggi University Hospital, Florence, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Mangiafico
mesh_terms: D002533:Cerebral Angiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents / Q000639:trends; D013997:Time Factors
keywords: Aneurysm; Intervention; Stent; Technique