title: Vascular angular remodeling by kissing-Y stenting in wide necked intracranial bifurcation aneurysms.
abstract: BACKGROUND
  Single stent deployment leads to a change in vascular geometry in wide necked bifurcation aneurysms. In some complex cases, the use of the single stent technique might not be sufficient or may not be feasible. The kissing-Y stenting technique appears to be an alternative endovascular treatment option. The aim of this study was to evaluate the effects of the kissing-Y stenting technique on vascular angular remodeling.
  
  
  METHODS
  21 patients with wide necked intracranial bifurcation aneurysms at different sites (10 anterior communicating artery, 6 middle cerebral artery, 3 basilar artery, 1 vertebral artery/posterior inferior cerebellar artery, 1 internal carotid artery/posterior communicating artery) were treated with 44 closed cell stents (follow-up 2012-2016) using the kissing-Y stenting technique. We analyzed vascular angle geometry between the mother and both affected daughter vessels by digital subtraction angiography, before and after stent deployment, using standard working projections.
  
  
  RESULTS
  Endovascular treatment of wide necked intracranial aneurysms using the kissing-Y stenting technique significantly decreased the angle between the bifurcation branches from 130.4±9.5° to 91.5±9.1° (p<0.0001).
  
  
  CONCLUSIONS
  Kissing-Y stenting in wide necked bifurcation aneurysms leads to vascular angular remodeling of both affected branches. The resulting straightening of the bifurcation angle may prevent aneurysmal recurrence.
authors.affiliation: Department of Radiology and Neuroradiology, Sana Kliniken Duisburg, Duisburg, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Melber
authors.affiliation: Department of Radiology and Neuroradiology, Sana Kliniken Duisburg, Duisburg, Germany.|Department of Diagnostic and Interventional Neuroradiology, Medical School Hannover, Hannover, Germany.
authors.forename: Dan
authors.initials: D
authors.lastname: Meila
authors.affiliation: Department of Radiology and Neuroradiology, Sana Kliniken Duisburg, Duisburg, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Draheim
authors.affiliation: Department of Radiology and Neuroradiology, Sana Kliniken Duisburg, Duisburg, Germany.
authors.forename: Dominik
authors.initials: D
authors.lastname: Grieb
authors.affiliation: Department of Radiology and Neuroradiology, Sana Kliniken Duisburg, Duisburg, Germany.
authors.forename: Björn
authors.initials: B
authors.lastname: Greling
authors.affiliation: Department of Radiology and Neuroradiology, Sana Kliniken Duisburg, Duisburg, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Schlunz-Hendann
authors.affiliation: Department of Radiology and Neuroradiology, Sana Kliniken Duisburg, Duisburg, Germany.
authors.forename: Friedhelm
authors.initials: F
authors.lastname: Brassel
mesh_terms: D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction / Q000379:methods*; D020771:Anterior Cerebral Artery / Q000000981:diagnostic imaging / Q000601:surgery; D001488:Basilar Artery / Q000000981:diagnostic imaging / Q000601:surgery; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000601:surgery; D057510:Endovascular Procedures / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015607:Stents; D016896:Treatment Outcome; D066253:Vascular Remodeling / Q000502:physiology
keywords: Aneurysm; Angiography; Intervention; Stent; Technique