E-143 Predicting the need for y-stenting in complex wide-neck bifurcation aneurysms. (23rd July 2022)

• Record Type: Journal Article
• Authors: Lauzier, D; Root, B; Osbun, J; Chatterjee, A; Moran, C; Kansagra, A
• Is Part Of: Journal of neurointerventional surgery. Volume 14(2022)Supplement 1
• Page Start: A153
• Page End: A154
• Publication Date: 2022-07-23
• Subjects: Nervous system -- Surgery -- Periodicals; Cerebrovascular disease -- Surgery -- Periodicals; 617.48
• DOI: 10.1136/neurintsurg-2022-SNIS.254
• Languages: English
• ISSNs: 1759-8478

Abstract

Abstract : Introduction: Stent-assisted coiling of wide neck bifurcation aneurysms in the anterior communicating artery and basilar tip region is performed utilizing various single and multi-stent configurations. One common configuration is the Y-stent configuration. While the safety and efficacy of Y-stenting have been studied, risk factors for the need for later Y-stenting remain unknown. Materials and Methods: Clinical and angiographic data were retrospectively obtained for patients that underwent stent-assisted coiling at our center. Patients were included in this study if stent-assisted coiling was performed using current generation Neuroform Atlas or LVIS Jr stents. A multivariate logistic regression was performed to measure the influence of aneurysm neck size, aneurysm dome to neck ratio, aneurysm location, and initial stent selection on the need for Y stenting. Results: Stent-assisted coiling was attempted to treat 82 aneurysms in 81 patients during the study period. Technical complications occurred in 7.3% (6/82) of stent-assisted coiling procedures, and clinical complications occurred following 6.1% (5/82) of procedures. In multivariate analysis, larger aneurysm neck size was associated with increased probability of needing Y-stenting (OR 1.85, 95% CI 1.18 - 2.89). No other factors were associated with increased risk of needing Y-stenting for successful stent-assisted coiling. Conclusion: Aneurysms with larger neck sizes are more likely to require Y-stenting when treated with stent-assisted coiling. Further study is necessary to optimize stent selection to improve technical feasibility of procedures, reduce procedural times, and minimize procedural costs. Disclosures: D. Lauzier: None. B. Root: None. J. Osbun: 2; C; Medtronic, Microvention. A. Chatterjee: None. C. Moran: 2; C; Medtronic, Cerenovus. A. Kansagra: 2; C; Microvention, Penumbra.