Small Tenuous Intracranial Arteries Can Well Tolerate the Deployment of 2 Stents in Y Configuration or an Overlapping Manner in Treating Intracranial Aneurysms.

Abstract

To investigate parent vessel response to deployment of 2 stents for treatment of cerebral aneurysms. Fifteen patients (11 women and 4 men; age range, 25-83 years) with 18 wide-necked intracranial aneurysms were treated with 2 stents with or without subsequent coiling. The vascular diameter was measured and compared within the native parent artery, and the single stent and double stent were measured and compared before and immediately after stenting and at angiographic follow-up. Thirty stents were deployed. Before stenting, the mean vessel diameter was 3.4 ± 0.21 mm at point A, 3.06 ± 0.18 mm at point B, 3.16 ± 0.21 mm at point C, 2.67 ± 0.27 mm at point D, and 2.56 ± 0.23 mm at point E. The deployment of 2 stents resulted in statistically significant increases in both the average vascular diameter and cross-sectional area at points C (3.51 ± 0.22 mm, P = 0.0006; and 9.76 ± 1.17 mm², P = 0.001, respectively) and E (2.88 ± 0.32 mm, P = 0.01; and 7.28 ± 1.46 mm², P = 0.02, respectively) compared with prestenting. At angiographic follow-ups, compared with before stenting, significant increases were documented at point C (3.42 ± 0.22 mm and 9.42 ± 1.37 mm², respectively) at first angiographic follow-up but at points A (3.62 ± 0.45 mm and 10.51 ± 2.37 mm², respectively) and B (3.26 ± 0.24 mm and 8.47±1.26 mm², respectively) at second angiographic follow-up. No significant vascular stenosis was demonstrated at the double-stent segment compared with the single-stent or native artery segments. The small tenuous cerebral arteries can well tolerate the deployment of 2 stents for the treatment of intracranial aneurysms.