Drill turn technique for enhanced visualization of wide-neck bifurcation aneurysms in Y-stent-assisted coiling with LVIS EVO stents: technical considerations and mid-term results


Islak C., Ozluk E., Yakupoglu A., KIZILKILIÇ O., Velioglu M., Cekirge S., ...Daha Fazla

NEURORADIOLOGY, cilt.67, sa.1, ss.227-234, 2025 (SCI-Expanded, Scopus) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 67 Sayı: 1
  • Basım Tarihi: 2025
  • Doi Numarası: 10.1007/s00234-024-03447-3
  • Dergi Adı: NEURORADIOLOGY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, Biotechnology Research Abstracts, CINAHL
  • Sayfa Sayıları: ss.227-234
  • Anahtar Kelimeler: Aneurysm, Bifurcation, Coil, Embolization, LVIS-EVO, SAPT, Y-Stent
  • İstanbul Üniversitesi-Cerrahpaşa Adresli: Evet

Özet

BackgroundCrossing Y-stent-assisted coiling (CYSAC) is a feasible yet technically challenging technique for the treatment of wide-neck bifurcation aneurysms (WNBAs).ObjectiveTo present mid-term results of Y-stent-assisted coiling (YSAC) using the LVIS EVO stent and to describe our "drill turn" technique for stent crossing.MethodsThis retrospective, observational study included 37 consecutive patients treated with YSAC using LVIS EVO stents at five centres between September 2020 and March 2023.ResultsImmediately after treatment, 31 of the 37 patients (83.8%) achieved Raymond-Roy occlusion classification (RROC) Class I occlusion, while 5 patients (13.5%) had Class II and 1 patient (2.7%) had Class III occlusion. The mean follow-up period was 32.8 months (range: 11-41 months), and all patients underwent follow-up imaging after >= 6 months. On follow-up imaging, 34 patients (92%), including all those with immediate RROC Class I occlusion, 2 with Class II, and 1 with Class III, showed Class I occlusion. One patient with RROC Class II occlusion demonstrated a gradual decrease in residual filling, while one large partially thrombosed middle cerebral artery aneurysm and one large basilar tip aneurysm (8%) with residual neck filling remained unchanged on the 6-month digital subtraction angiograph.ConclusionUtilizing the described drill turn technique, CYSAC with LVIS EVO stents was found to be feasible and safe for WNBA treatment, with high and stable occlusion rates observed during mid-term follow-up.