title: Kissing-Y stenting for endovascular treatment of complex wide necked bifurcation aneurysms using Acandis Acclino stents: results and literature review.
abstract: BACKGROUND
  Y-configured stent assisted coiling is a promising therapeutic option to ensure safe coil embolization and preserve the affected arteries in complex wide necked aneurysms. We present our experience with self-expanding Acandis Acclino stents for the treatment of complex aneurysms using the kissing-Y technique.
  
  
  METHODS
  We retrospectively reviewed seven patients with seven complex aneurysms (three anterior communicating artery (AcomA), two middle cerebral artery, one basilar artery/superior cerebellar artery, and one vertebral artery/posterior inferior cerebellar artery) who were treated with the kissing-Y technique by stent assisted coiling from June 2013 to July 2014, with follow-up until January 2015. DSA follow-up was up to 17 months, with a mean follow-up period of 10 months. Six patients were treated electively and one in the acute phase of a subarachnoid hemorrhage. In all cases, closed cell Acandis Acclino stents were used. We evaluated procedural complications, clinical outcomes, and mid term angiographic follow-up. Additionally, a literature review is provided.
  
  
  RESULTS
  In all patients, stents were successfully placed and implanted. One patient developed a periprocedural thromboembolic complication not directly related to the stents. No other periprocedural or postprocedural complications were encountered. Follow-up examinations showed stable and total occlusion of all coiled aneurysms.
  
  
  CONCLUSIONS
  The results of our study show that the kissing-Y technique using closed cell Acandis Acclino stents followed by coil embolization is a feasible treatment option for selected complex bifurcation aneurysms.
authors.affiliation: Department of Radiology and Neuroradiology, Klinikum Duisburg-Sana Kliniken, Duisburg, Germany.
authors.forename: Friedhelm
authors.initials: F
authors.lastname: Brassel
authors.affiliation: Department of Radiology and Neuroradiology, Klinikum Duisburg-Sana Kliniken, Duisburg, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Melber
authors.affiliation: Department of Radiology and Neuroradiology, Klinikum Duisburg-Sana Kliniken, Duisburg, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Schlunz-Hendann
authors.affiliation: Department of Radiology and Neuroradiology, Klinikum Duisburg-Sana Kliniken, Duisburg, Germany Department of Diagnostic and Interventional Neuroradiology, Medical School Hannover, Hannover, Germany.
authors.forename: Dan
authors.initials: D
authors.lastname: Meila
mesh_terms: D000368:Aged; D015901:Angiography, Digital Subtraction; D001807:Blood Vessel Prosthesis; D057510:Endovascular Procedures / Q000379:methods*; D004867:Equipment Design; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents / Q000706:statistics & numerical data; D016896:Treatment Outcome
keywords: Aneurysm; Device; Intervention; Stent; Technique