By collecting clinical and radiological data we evaluated from January 2007 through December 2013, 20 wide-necked bifurcation aneurysms. We retrospectively evaluated the efficacy and safety of the crossing Y-stent technique for coiling of wide-necked bifurcation aneurysms. Ko, Jun Kyeung Han, In Ho Cho, Won Ho Choi, Byung Kwan Cha, Seung Heon Choi, Chang Hwa Lee, Sang Weon Lee, Tae Hongĭouble stenting in a Y-configuration is a promising therapeutic option for wide-necked cerebral aneurysms not amenable to reconstruction with a single stent. Finally, the results show that the risk of vessel rupture in the cerebral aneurysm with a circular neck is 40.8% higher than that in the case of the cerebral aneurysm with an elliptical neck.Ĭrossing Y-stent technique with dual open-cell stents for coiling of wide-necked bifurcation aneurysms. The blood flow becomes slightly more turbulent after the occurrence of the cerebral aneurysm, though it still remains in the range of the laminar flow and the pulsatility of the blood flow in patients is 28-45% greater than that of the normal subject. The increase in these parameters for patients with a circular neck is more pronounced than that with an elliptical neck. Although the blood hemodynamics parameters increase after the occurrence of the disease, the largest increase is in the wall shear stress (by a factor of 4.1-6.5) as compared to the normal subject. In this study, one normal subject and two patients suffering from a cerebral aneurysm with circular and elliptical necks are analyzed by using the fluid-structure interaction (FSI) method. All rights reserved.īiomechanical Simulation to Compare the Blood Hemodynamics and Cerebral Aneurysm Rupture Risk in Patients with Different Aneurysm Necks If this is not possible, craniotomy and clip ligation will be required if complete aneurysm obliteration is the goal. Advanced endovascular techniques are needed to obliterate aneurysms in which the secondary branch(es) arise from the aneurysm neck. Secondary branch origin from the aneurysm neck varied depending on the aneurysm group. Although protection of these neck perforators will be difficult, their identification may be even more challenging. A subgroup of anterior communicating artery region aneurysms had a high incidence of perforator origin from the aneurysm neck. ![]() Perforator origin from the aneurysm neck was infrequent. The location of secondary branch origin from the aneurysm neck varied depending on the aneurysm group. Aneurysms arising from the anterior communicating artery between the anterior cerebral arteries had a high incidence of perforator origin from the aneurysm neck. The incidence of perforator origin from the aneurysm neck was as follows: basilar, 1/15 (7%) internal carotid artery bifurcation, 4/23 (17%) main stem of the middle cerebral artery/secondary branch of the middle cerebral artery, 6/52 (12%) anterior communicating artery region, 5/46 (11%) and distal bifurcation vessels, 0/6 (0%). ![]() From a series of microsurgically clipped saccular cerebral aneurysms, 142 bifurcation aneurysms had detailed imaging studies and operative records that could be analyzed. ![]() These two features were considered important for treatment. Perforator and secondary branch origin in relation to the neck of cerebral, saccular bifurcation aneurysms were analyzed. Perforator and secondary branch origin in relation to the neck of saccular, cerebral bifurcation aneurysms.
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