J Cerebrovasc Endovasc Neurosurg.  2016 Mar;18(1):38-41. 10.7461/jcen.2016.18.1.38.

Open-cell Stent Deployment across the Wide Neck of a Large Middle Cerebral Aneurysm Using the Stent Anchor Technique

• Sakamoto S
• Shibukawa
• Tani I
• Oki S
• Kurisu K

• KMID: 2161701
• DOI: http://doi.org/10.7461/jcen.2016.18.1.38

Abstract

We describe a case of successful open-cell stent deployment across the wide neck of a large middle cerebral artery aneurysm using the stent anchor technique. A microcatheter was looped through the aneurysm and navigated into a distal vessel across the aneurysm neck. Although the loop of the microcatheter in the aneurysm straightened as it was gently withdrawn, the microcatheter again protruded into the aneurysm by open-cell stent navigation. The stent was partially deployed in a vessel distal to the aneurysm neck, withdrawn slowly to straighten the loop of the microcatheter in the aneurysm, and completely deployed across the aneurysm neck. After successful stent deployment, stent-assisted coil embolization was performed without complications. The stent anchor technique was successfully used to deploy an open-cell stent across the aneurysm neck in this case of microcatheter protrusion into the aneurysm during stent navigation.

Keyword

Endovascular procedures; Endovascular techniques; Intracranial aneurysm; Stent; Subarachnoid hemorrhage

MeSH Terms

Aneurysm
Embolization, Therapeutic
Endovascular Procedures
Intracranial Aneurysm*
Neck*
Stents*
Subarachnoid Hemorrhage

Figure

• 

  Fig. 1 (A) Digital subtraction angiogram of the left internal carotid artery showing a large wide-necked aneurysm with an inferior M2 branch arising from the aneurysm body at the middle cerebral artery bifurcation. (B) The loop of the microcatheter in the aneurysm was straightened by its slow withdrawal. Arrow, marker of the microcatheter. (C) The distal end of the stent was navigated distal to the aneurysm neck by the creation of a loop of the microcatheter in the aneurysm by stent advancement. Arrow, marker of the microcatheter; white asterisk, distal stent marker; black asterisk, proximal stent marker. (D) The loop of the microcatheter in the aneurysm was straightened by withdrawal of the microcatheter and stent leaving the stent partially deployed. Arrow, marker of the microcatheter; white asterisk, distal stent marker; black asterisk, proximal stent marker. (E) Digital subtraction angiogram of the left internal carotid artery showing successful stent deployment. White asterisk, distal stent marker; black asterisk, proximal stent marker. (F) Final digital subtraction angiogram showing complete aneurysm obliteration with patency of the inferior M2 branch.

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