Abstract
A 57-year-old male patient presenting with syncope was found to have a large wide-necked aneurysm arising from the bifurcation of the right internal carotid artery (ICA). He was a smoker, and his medical history included hypertension and hepatitis B. The patient’s aneurysm was successfully treated with stent-assisted coiling techniques using a Barrel Vascular Reconstruction Device (Barrel VRD; Medtronic) resulting in an excellent clinical outcome with no neurological deficit. Digital subtraction angiography (DSA) follow-up at 24 months confirmed the continued complete occlusion of the aneurysm. Although mild neointimal hyperplasia was seen on the follow-up DSA, the patient remained asymptomatic. Using the Barrel VRD as an assist device in wide-necked bifurcation aneurysms is the main topic of this chapter.
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References
Baxter BW, Rosso D, Lownie SP. Double microcatheter technique for detachable coil treatment of large, wide-necked intracranial aneurysms. AJNR Am J Neuroradiol. 1998;19(6):1176–8.
Bodily KD, Cloft HJ, Lanzino G, Fiorella DJ, White PM, Kallmes DF. Stent-assisted coiling in acutely ruptured intracranial aneurysms: a qualitative, systematic review of the literature. AJNR Am J Neuroradiol. 2011;32(7):1232–6. https://doi.org/10.3174/ajnr.A2478.
Fernandez Zubillaga A, Guglielmi G, Viñuela F, Duckwiler GR. Endovascular occlusion of intracranial aneurysms with electrically detachable coils: correlation of aneurysm neck size and treatment results. AJNR Am J Neuroradiol. 1994;15(5):815–20.
Gory B, Blanc R, Turjman F, Berge J, Piotin M. The barrel vascular reconstruction device for endovascular coiling of wide-necked intracranial aneurysms: a multicenter, prospective, post-marketing study. J Neurointerv Surg. 2018. pii: neurintsurg-2017-013602; https://doi.org/10.1136/neurintsurg-2017-013602.
Kabbasch C, Mpotsaris A, Maus V, Altenbernd JC, Loehr C. The barrel vascular reconstruction device: a retrospective, observational multicentric study. Clin Neuroradiol. 2018; https://doi.org/10.1007/s00062-017-0660-2.
Kelly ME, Gonugunta V, Woo HH, Turner R 4th, Fiorella D. Double-balloon trapping technique for embolization of a large wide-necked superior cerebellar artery aneurysm: case report. Neurosurgery. 2008;63(4 Suppl 2):291–2; discussion 292. https://doi.org/10.1227/01.NEU.0000316432.05038.F1.
Ko JK, Han IH, Cho WH, Choi BK, Cha SH, Choi CH, Lee SW, Lee TH. Crossing Y-stent technique with dual open-cell stents for coiling of wide-necked bifurcation aneurysms. Clin Neurol Neurosurg. 2015;132:54–60. https://doi.org/10.1016/j.clineuro.2015.02.002.
Lazzaro MA, Darkhabani Z, Zaidat OO, Fitzsimmons BF. Initial experience with the coaxial dual-lumen ascent balloon catheter for wide-neck aneurysm coil embolization. Front Neurol. 2011;19(2):52. https://doi.org/10.1227/01.neu.0000310190.66152.5710.3389/fneur.2011.00052.
Pierot L, Cognard C, Anxionnat R, Ricolfi F, CLARITY Investigators. Remodeling technique for endovascular treatment of ruptured intracranial aneurysms had a higher rate of adequate postoperative occlusion than did conventional coil embolization with comparable safety. Radiology. 2011;258(2):546–53. https://doi.org/10.1148/radiol.10100894.
Sakamoto S, Ohba S, Shibukawa M, Kiura Y, Okazaki T, Arita K, Kurisu K. Characteristics of aneurysms of the internal carotid artery bifurcation. Acta Neurochir. 2006;148(2):139–43; discussion 143. https://doi.org/10.1007/s00701-005-0682-4.
Setton A, Prestigiacomo CJ, Niimi Y, Xavier A, Farrow MG, Berenstein A. Dual microcatheter technique for the treatment of aneurysms with relatively wide necks: paper 35. Neurosurgery. 2006;58(2):407. https://doi.org/10.1227/01.neu.0000310190.66152.57.
Shapiro M, Babb J, Becske T, Nelson PK. Safety and efficacy of adjunctive balloon remodeling during endovascular treatment of intracranial aneurysms: a literature review. AJNR Am J Neuroradiol. 2008;29(9):1777–81. https://doi.org/10.3174/ajnr.A1216.
Spiotta AM, Gupta R, Fiorella D, Gonugunta V, Lobo B, Rasmussen PA, Moskowitz SI. Mid-term results of endovascular coiling of wide-necked aneurysms using double stents in a Y configuration. Neurosurgery. 2011;69(2):421–9. https://doi.org/10.1227/NEU.0b013e318214abbd.
Thorell WE, Chow MM, Woo HH, Masaryk TJ, Rasmussen PA. Y-configured dual intracranial stent-assisted coil embolization for the treatment of wide-necked basilar tip aneurysms. Neurosurgery. 2005;56(5):1035–40; discussion 1035-40
Yang P, Zhao K, Zhou Y, Zhao R, Zhang L, Zhao W, Hong B, Xu Y, Huang Q, Krings T, Liu J. Stent-assisted coil placement for the treatment of 211 acutely ruptured wide-necked intracranial aneurysms: a single-center 11-year experience. Radiology. 2015;276(2):545–52. https://doi.org/10.1148/radiol.2015140974.
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Perez, N., Lylyk, I., Nella Castro, R., Scrivano, E., Lylyk, P. (2019). Internal Carotid Artery Bifurcation Aneurysm: Large Wide-Necked Bifurcation Aneurysm; Stent-Assisted Coiling Technique Using a Barrel Vascular Reconstruction Device; Technical Aspects and Follow-up Results. In: Henkes, H., Lylyk, P., Ganslandt, O. (eds) The Aneurysm Casebook. Springer, Cham. https://doi.org/10.1007/978-3-319-70267-4_12-1
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