TY - JOUR
T1 - Need for Y-stenting in stent-assisted coiling of wide-neck bifurcation aneurysms
AU - Lauzier, David C.
AU - Root, Brandon K.
AU - Chatterjee, Arindam R.
AU - Osbun, Joshua W.
AU - Moran, Christopher J.
AU - Kansagra, Akash
N1 - Funding Information:
N/A. All authors have met ICMJE criteria for authorship, and all authors have read and approved the submitted manuscript. Study conception: DCL and APK. Data collection: DCL, BKR, JWO, ARC, CJM, APK. Data analysis: DCL and APK. Manuscript writing: DCL and APK. Critical revision: BKR, JWO, ARC, CJM, APK. Final approval: DCL, BKR, JWO, ARC, CJM, APK.
Publisher Copyright:
© 2023 Elsevier B.V.
PY - 2023/6
Y1 - 2023/6
N2 - Background and Purpose: Stent-assisted coiling of wide neck bifurcation aneurysms in the anterior communicating segment and basilar tip region can be performed with varying stent configurations, including single stenting or Y-stenting. Y-stenting requires two stents and thus incurs greater cost and procedural complexity than single-stent constructs. The influence of first stent type on the need for Y-stenting remains unknown. Materials and Methods: Clinical and angiographic data were retrospectively obtained for patients that underwent stent-assisted coiling for basilar tip or anterior communicating aneurysms at a high-volume center. Patients were included in this study if stent-assisted coiling was performed using Neuroform Atlas or LVIS Jr stents. A multivariate binary logistic regression was performed to measure the influence of first stent type on the need for Y-stenting. Results: Stent-assisted coiling was used to treat 82 aneurysms in 81 patients during the study period, and Y-stenting was performed in 18.3% (15/82) of cases. In multivariate logistic regression analysis, use of LVIS Jr. as the first stent did not significantly influence the need for subsequent Y-stenting after controlling for aneurysm morphology (OR 0.65, 95% CI 0.18–2.43). Conclusion: Controlling for aneurysm morphology and location, the use of Y-stenting for stent-assisted coiling was not independently influenced by the choice of LVIS Jr or Neuroform Atlas as the first stent. A larger cohort may reveal differences between these two stents, particularly for aneurysms with large neck sizes.
AB - Background and Purpose: Stent-assisted coiling of wide neck bifurcation aneurysms in the anterior communicating segment and basilar tip region can be performed with varying stent configurations, including single stenting or Y-stenting. Y-stenting requires two stents and thus incurs greater cost and procedural complexity than single-stent constructs. The influence of first stent type on the need for Y-stenting remains unknown. Materials and Methods: Clinical and angiographic data were retrospectively obtained for patients that underwent stent-assisted coiling for basilar tip or anterior communicating aneurysms at a high-volume center. Patients were included in this study if stent-assisted coiling was performed using Neuroform Atlas or LVIS Jr stents. A multivariate binary logistic regression was performed to measure the influence of first stent type on the need for Y-stenting. Results: Stent-assisted coiling was used to treat 82 aneurysms in 81 patients during the study period, and Y-stenting was performed in 18.3% (15/82) of cases. In multivariate logistic regression analysis, use of LVIS Jr. as the first stent did not significantly influence the need for subsequent Y-stenting after controlling for aneurysm morphology (OR 0.65, 95% CI 0.18–2.43). Conclusion: Controlling for aneurysm morphology and location, the use of Y-stenting for stent-assisted coiling was not independently influenced by the choice of LVIS Jr or Neuroform Atlas as the first stent. A larger cohort may reveal differences between these two stents, particularly for aneurysms with large neck sizes.
KW - Aneurysm
KW - Coil
KW - Stent-coil
KW - Y-stent
UR - http://www.scopus.com/inward/record.url?scp=85154066267&partnerID=8YFLogxK
U2 - 10.1016/j.clineuro.2023.107748
DO - 10.1016/j.clineuro.2023.107748
M3 - Article
C2 - 37146368
AN - SCOPUS:85154066267
SN - 0303-8467
VL - 229
JO - Clinical Neurology and Neurosurgery
JF - Clinical Neurology and Neurosurgery
M1 - 107748
ER -