Temporary Semi-Jailing Technique Avoiding Inevitable Antiplatelet Medication for Coil Embolization of Wide-necked Cerebral Aneurysms.

Lu,  Peng Hua; Kim,  Jong Lim; Shin,  Jin Ho; Kim,  Sang Joon; Lee,  Deok Hee; Choi,  Choong Gon; Suh,  Dae Chul

doi:2010.5.2.103

Neurointervention > Volume 5(2); 2010 > Article

Original Article

Neurointervention 2010;5(2):103-109.
DOI: https://doi.org/10.5469/neuroint.2010.5.2.103

Temporary Semi-Jailing Technique Avoiding Inevitable Antiplatelet Medication for Coil Embolization of Wide-necked Cerebral Aneurysms.

Peng Hua Lu, Jong Lim Kim, Jin Ho Shin, Sang Joon Kim, Deok Hee Lee, Choong Gon Choi, Dae Chul Suh

¹Department of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea. dcsuh@amc.seoul.kr
²Department of Radiology, Jiangsu Subei People's Hospital, The First Affiliated Hospital of Yangzhou University, Yangzhou 225001, People's Republic of China.

Abstract

PURPOSE
Stent-assisted neck remodeling for wide-necked aneurysms requires long-term medication with antiplatelet agents. We describe here a temporary semi-jailing technique (SJT) for wide-necked aneurysms that avoids the need for antiplatelet medications.
MATERIALS AND METHODS
Among 101 patients who underwent stent- and/or balloon-assisted embolizations, 3 wide-necked aneurysms, including 1 ruptured aneurysm, underwent the temporary SJT using Enterprise stents. Temporary SJTs were used due to resistance to antiplatelet agents prior to cardiac surgery or to a ruptured aneurysm with a wide neck. The aneurysms were located in the middle cerebral artery, the paraclinoid internal carotid artery segment, and the posterior communicating artery.
RESULTS
Enterprise stents were retrieved after coiling without any change in coil mass stability. The final angiogram showed good patency of each parent artery, good stability of the coil mass and total occlusion of the aneurysm. None of the patients experienced any periprocedural or delayed neurological complications. While retrieving the stent from tortuous vessels, we experienced the jumping phenomenon associated with this device.
CONCLUSION
Temporary SJTs have the advantage of stent retrieval, thus avoiding inevitable antiplatelet medication. However, care should be taken in tortuous vessels to avoid the jumping phenomenon associated with the device.

Key Words: Aneurysm; Stent; Stent-assisted coiling; Wide neck