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J Clin Neurosci. 2014 May;21(5):852-4. doi: 10.1016/j.jocn.2013.10.009. Epub 2013 Oct 30.

Temporary stent scaffolding during aneurysm coiling.

Author information

1
Bernard and Irene Schwartz Interventional Neuroradiology Section, Department of Radiology, NYU Langone Medical Center, New York University School of Medicine, 660 First Avenue, 7th Floor, New York, NY 10016, USA; Department of Neurosurgery, NYU Langone Medical Center, New York University School of Medicine, New York, NY, USA. Electronic address: daniel.zumofen@nyumc.org.
2
Department of Neurosurgery, NYU Langone Medical Center, New York University School of Medicine, New York, NY, USA.
3
Bernard and Irene Schwartz Interventional Neuroradiology Section, Department of Radiology, NYU Langone Medical Center, New York University School of Medicine, 660 First Avenue, 7th Floor, New York, NY 10016, USA; Department of Neurosurgery, NYU Langone Medical Center, New York University School of Medicine, New York, NY, USA; Department of Neurology, NYU Langone Medical Center, New York University School of Medicine, New York, NY, USA.
4
Bernard and Irene Schwartz Interventional Neuroradiology Section, Department of Radiology, NYU Langone Medical Center, New York University School of Medicine, 660 First Avenue, 7th Floor, New York, NY 10016, USA.
5
Bernard and Irene Schwartz Interventional Neuroradiology Section, Department of Radiology, NYU Langone Medical Center, New York University School of Medicine, 660 First Avenue, 7th Floor, New York, NY 10016, USA; Department of Neurology, NYU Langone Medical Center, New York University School of Medicine, New York, NY, USA.

Abstract

We report a case of temporary Solitaire FR stent (Covidien, Mansfield, MA, USA) scaffolding to reduce coil herniation during embolization of a large neck anterior communicating artery aneurysm. In contrast to classic stent-assisted coiling, the fully retrievable stent is recaptured prior to detachment of the last coil. The presented technical nuance hence does not require institution of prolonged antiplatelet coverage. But the door is left open for coil-repositioning in case of coil basket instability. Permanent stent redeployment remains a fall-back option if critical hardware conflict occurs. In comparison to classic balloon remodeling, the presented method may offer easier distal access, particularly in tortuous arterial anatomy. Temporary occlusion of the parent artery, side branches, and perforators is also avoided. Given its specific potential advantages, temporary stent scaffolding using the fully retrievable Solitaire FR device may find its niche as a bailout option, primarily in a very specific subset of distally located wide neck aneurysms.

KEYWORDS:

Aneurysm; Balloon remodeling; Coiling; Stent; Stent remodeling

PMID:
24331624
DOI:
10.1016/j.jocn.2013.10.009
[Indexed for MEDLINE]

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