Three Cases with Wide-necked Cerebral Aneurysms in Whom the T-stent Technique Was Useful

• Published in: Journal of Neuroendovascular Therapy 2018, Vol.12(8), pp.409-415
• Main Authors: Morinaga, Yusuke, Nii, Kouhei, Hiraoka, Fumihiro, Sakamoto, Kimiya, Inoue, Ritsurou, Mitsutake, Takafumi, Eto, Ayumu, Hanada, Hayatsura, Tsutsumi, Masanori
• Format: Article
• Language: English
• Subjects: large broad-necked aneurysm; stent-assisted coil embolization; T-stent technique
• ISSN: 1882-4072; 2186-2494
• DOI: 10.5797/jnet.tn.2017-0127

Purpose: We report three patients with wide-necked cerebral aneurysms in whom the T-stent technique with a low-profile visualized intraluminal support (LVIS) Jr. was useful, and review its usefulness and tips.Case Presentations: Case 1: A 75-year-old male with a left internal carotid-posterior communicating (IC-PC) aneurysm (maximum diameter: 11 mm, neck diameter: 7.0 mm). The posterior communicating (P-com; 2.3 mm) had branched from the aneurysmal dome. Stent-assisted coil embolization (SACE) was performed by inserting an LVIS Jr. 3.5 × 28 on the fetal-type posterior cerebral artery (PCA). P-com side and an LVIS Jr. 3.5 × 18 on the internal carotid artery (ICA) side (T-stent technique).Case 2: An 80-year-old female with a right IC-PC aneurysm (maximum diameter: 6.0 mm, neck diameter: 5.4 mm). The P-com (2.2 mm) had branched from the aneurysmal dome. SACE was performed by inserting an LVIS Jr. 2.5 × 13 on the fetal-type PCA. P-com side and a Neuroform Atlas 4.5 × 21 on the ICA side.Case 3: A 61-year-old female with a left vertebral artery (VA)-posterior inferior cerebellar artery (PICA) aneurysm (maximum diameter: 6.4 mm, neck diameter: 5.6 mm, PICA diameter: 2.2 mm). SACE was performed by inserting an LVIS Jr. 2.5 × 13 on the PICA side and an LVIS Blue 4.5 × 23 on the VA side.Conclusion: The T-stent technique with an LVIS Jr. was useful for achieving neck formation for a wide-necked aneurysm directly branching from an aneurysm or preserving branches measuring ≥2 mm in diameter. We reported its tips.