Dual stenting using low-profile LEO baby stents for the endovascular management of challenging intracranial aneurysms

AJNR Am J Neuroradiol. 2015 Feb;36(2):323-9. doi: 10.3174/ajnr.A4106. Epub 2014 Sep 18.

Abstract

Background and purpose: Endovascular treatment of wide-neck, complex, and distally located cerebral aneurysms is a challenging issue. This study evaluated the safety and efficacy of dual stent placement by using a low-profile stent system (LEO Baby) for the treatment of challenging distal intracranial aneurysms.

Materials and methods: We retrospectively reviewed patients in whom at least 1 LEO Baby stent was used in the context of dual stent placement for the treatment of intracranial aneurysms. Patients who were treated with dual stent-assisted coil embolization and telescopic implantation of LEO Baby stents were included in the study. Clinical and angiographic findings, procedural data, and follow-up are reported.

Results: Twelve patients were included in this study. Three patients presented with subarachnoid hemorrhage in the subacute-chronic phase, and the remaining patients had unruptured aneurysms. Nine patients were treated by using the dual stent-assisted coiling method. X- (nonintersecting), Y- (intersecting and reversible), T-, and parallel-stent configurations were performed for the dual stent-assisted coiling procedures. Three patients were treated by using telescopic stent placement for a flow diverter-like effect. The procedures were successful in all cases. Technical complications without a significant clinical adverse event developed in 2 patients. The 3- and 6-month control MRAs and DSAs demonstrated complete occlusion of the aneurysms in all patients except 1. All patients had good clinical outcomes on follow-up (mRS ≤1).

Conclusions: The results of this small study showed the feasibility of dual stent placement by using low-profile LEO Baby stents to treat distally located complex intracranial aneurysms.

MeSH terms

  • Adult
  • Aged
  • Blood Vessel Prosthesis* / adverse effects
  • Cerebral Angiography / methods
  • Endovascular Procedures / instrumentation*
  • Female
  • Humans
  • Intracranial Aneurysm / surgery*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Stents* / adverse effects
  • Treatment Outcome