Abstract
An incidental wide-necked aneurysm on the bifurcation of the right middle cerebral artery with a temporal branch incorporated in the aneurysm base was treated by a specific protective stent-assisted coiling technique. Angiographic follow-up confirmed that the aneurysm had been successfully obliterated while the temporal branch remained patent. This case illustrates that the stent-assisted technique can also be used to safely treat wide-necked bifurcation aneurysms with a branch incorporated in the aneurysm base. This technique has consistently provided reliable and satisfactory results. Using a stent-assisted coiling technique to preserve a branch arising from the sac while adequately and securely occluding an aneurysm is the main topic of this report.
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Ferns SP, Sprengers ME, van Rooij WJ, Rinkel GJ, van Rijn JC, Bipat S, Sluzewski M, Majoie CB. Coiling of intracranial aneurysms: a systematic review on initial occlusion and reopening and retreatment rates. Stroke. 2009;40(8):e523–9. https://doi.org/10.1161/STROKEAHA.109.553099.
Kim BM, Park SI, Kim DJ, Kim DI, Suh SH, Kwon TH, Choi HS, Won YS. Endovascular coil embolization of aneurysms with a branch incorporated into the sac. AJNR Am J Neuroradiol. 2010;31(1):145–51. https://doi.org/10.3174/ajnr.A1785.
Kwon BJ, Seo DH, Ha YS, Lee KC. Endovascular treatment of wide-necked cerebral aneurysms with an acute angle branch incorporated into the sac: novel methods of branch access in 8 aneurysms. Neurointervention. 2012;7(2):93–101. https://doi.org/10.5469/neuroint.2012.7.2.93.
Lee JY, Seo JH, Cho YD, Kang HS, Han MH. Endovascular treatment of wide-neck intracranial aneurysms using a microcatheter protective technique: results and outcomes in 75 aneurysms. AJNR Am J Neuroradiol. 2011;32(5):917–22. https://doi.org/10.3174/ajnr.A2411.
Lubicz B, Lefranc F, Levivier M, Dewitte O, Pirotte B, Brotchi J, Balériaux D. Endovascular treatment of intracranial aneurysms with a branch arising from the sac. AJNR Am J Neuroradiol. 2006;27(1):142–7.
Lubicz B, Morais R, Bruyère PJ, Ligot N, Mine B. Stent-assisted coiling of wide-neck bifurcation aneurysms with a branch incorporated in the aneurysm base: long-term follow-up in 49 patients with 53 aneurysms. Neuroradiology. 2017;59(6):619–24. https://doi.org/10.1007/s00234-017-1834-y.
Phan K, Huo YR, Jia F, Phan S, Rao PJ, Mobbs RJ, Mortimer AM. Meta-analysis of stent-assisted coiling versus coiling-only for the treatment of intracranial aneurysms. J Clin Neurosci. 2016;31:15–22. https://doi.org/10.1016/j.jocn.2016.01.035.
Pierot L, Cognard C, Anxionnat R, Ricolfi F, CLARITY Investigators. Endovascular treatment of ruptured intracranial aneurysms: factors affecting midterm quality anatomic results: analysis in a prospective, multicenter series of patients (CLARITY). AJNR Am J Neuroradiol. 2012;33(8):1475–80. https://doi.org/10.3174/ajnr.A3003.
Xiaoxi Z, Jing C, Qinghai H, Jianmin L, Bo H, Dongwei D. Microcatheter looping technique facilitates the embolization of complex intracranial aneurysms with an acute angle branch incorporated into the sac. World Neurosurg. 2017;100:56–61. https://doi.org/10.1016/j.wneu.2016.12.093.
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Bonnet, T., Mine, B., Lubicz, B. (2019). Middle Cerebral Artery Bifurcation Aneurysm: Incidental Wide-Necked Aneurysm, MCA Branch Incorporated in the Aneurysm Base, and Treatment with Stent-Assisted Coiling Technique. In: Henkes, H., Lylyk, P., Ganslandt, O. (eds) The Aneurysm Casebook. Springer, Cham. https://doi.org/10.1007/978-3-319-70267-4_72-1
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DOI: https://doi.org/10.1007/978-3-319-70267-4_72-1
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