title: LVIS Jr 'shelf' technique: an alternative to Y stent-assisted aneurysm coiling.
abstract: Wide-necked bifurcation intracranial aneurysms have traditionally not been amenable to coil embolization with the use of a single stent due to the high risk of coil prolapse. Y-configuration double stent-assisted coil embolization ('Y-stenting') of this aneurysm type has been shown to have generally good clinical outcomes, although the technique is complex with various challenges described in the literature. The compliant and flexible closed-cell design of braided stents such as the LVIS Jr allows for the creation of a 'shelf' across the aneurysm neck sufficient to prevent coil prolapse. We describe this novel 'shelf' technique and present a small case series of LVIS Jr stent-assisted wide-necked bifurcation intracranial aneurysm coiling in eight patients. Our small, albeit important, case series demonstrates that the 'shelf' technique is feasible and safe with very good short-term clinical and angiographic outcomes, and may obviate the need for Y-stenting.
authors: Department of Diagnostic Radiology, Dalhousie University, Halifax, Nova Scotia, Canada.
authors: Elizabeth Hai Yen
authors: EHY
authors: Du
authors: Division of Neuroradiology, Department of Diagnostic Imaging, QE II Health Sciences Center, Halifax, Nova Scotia, Canada.
authors: Jai Jai Shiva
authors: JJS
authors: Shankar
keywords: Aneurysm; Coil; Device; Intervention; Stent