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Evaluation of a neck-bridge device to assist endovascular treatment of wide-neck aneurysms of the anterior circulation

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Abstract
BACKGROUND AND PURPOSE: Intracranial aneurysms with a wide-neck or an unfavorable dome-to-neck ratio may be difficult to treat properly and safely. Our aim was to evaluate the TriSpan neck-bridge device to assist coiling of wide-neck bifurcation aneurysms in the anterior circulation. MATERIALS AND METHODS: In 14 patients, we performed 16 TriSpan-assisted coil embolizations with wide-neck bifurcation aneurysms of the anterior circulation. Eleven procedures were indicated for acutely ruptured aneurysms. Five were performed electively for the following: recurrent aneurysm after coil only (n = 1) or after TriSpan-assisted embolization (n = 2), aneurysm remnant after clipping (n = 1), and aneurysm incidentally found in = 1). Procedural and clinical complications were recorded. Follow-up angiography was performed, and clinical outcomes were assessed by using the modified Rankin Scale score. RESULTS: TriSpan-assisted embolization was successful in 15/16 (93.8%) procedures, with complete occlusion in 2/16 (12.5%), near-complete occlusion in 10/16 (62.5%), and incomplete occlusion in 3/16 (18.75%). There were 6 (37.5%) intraprocedural complications: thrombus formation (n = 3), protrusion of a TriSpan loop in the parent artery (n = 1), TriSpan displacement in the aneurysm (n = 1), and tangling of a coil loop in the device (n = 1). Three patients died in the hospital (21.4%). Follow-up angiography or MR angiography was available in 8 (57.1%) patients and showed complete (n 2), near-complete (n = 2), and incomplete occlusion (n = 4). Long-term clinical outcome was no (n = 4) or minor symptoms (n = 1) and moderate (n 2), moderately severe (n = 2), or severe handicap (n 2). CONCLUSION: The use of the TriSpan device is feasible in the anterior circulation and can assist treatment of difficult wide-neck bifurcation aneurysms.
Keywords
MICROCATHETER, EMBOLIZATION, RECONSTRUCTION, BALLOON, BIFURCATION ANEURYSMS, CEREBRAL ANEURYSMS, RUPTURED INTRACRANIAL ANEURYSMS, GUGLIELMI DETACHABLE COILS

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Please use this url to cite or link to this publication:

Chicago
DE KEUKELEIRE, KATRIEN, Peter Vanlangenhove, and Luc Defreyne. 2008. “Evaluation of a Neck-bridge Device to Assist Endovascular Treatment of Wide-neck Aneurysms of the Anterior Circulation.” American Journal of Neuroradiology 29 (1): 73–78.
APA
DE KEUKELEIRE, K., Vanlangenhove, P., & Defreyne, L. (2008). Evaluation of a neck-bridge device to assist endovascular treatment of wide-neck aneurysms of the anterior circulation. AMERICAN JOURNAL OF NEURORADIOLOGY, 29(1), 73–78.
Vancouver
1.
DE KEUKELEIRE K, Vanlangenhove P, Defreyne L. Evaluation of a neck-bridge device to assist endovascular treatment of wide-neck aneurysms of the anterior circulation. AMERICAN JOURNAL OF NEURORADIOLOGY. 2008;29(1):73–8.
MLA
DE KEUKELEIRE, KATRIEN, Peter Vanlangenhove, and Luc Defreyne. “Evaluation of a Neck-bridge Device to Assist Endovascular Treatment of Wide-neck Aneurysms of the Anterior Circulation.” AMERICAN JOURNAL OF NEURORADIOLOGY 29.1 (2008): 73–78. Print.
@article{415904,
  abstract     = {BACKGROUND AND PURPOSE: Intracranial aneurysms with a wide-neck or an unfavorable dome-to-neck ratio may be difficult to treat properly and safely. Our aim was to evaluate the TriSpan neck-bridge device to assist coiling of wide-neck bifurcation aneurysms in the anterior circulation. 
MATERIALS AND METHODS: In 14 patients, we performed 16 TriSpan-assisted coil embolizations with wide-neck bifurcation aneurysms of the anterior circulation. Eleven procedures were indicated for acutely ruptured aneurysms. Five were performed electively for the following: recurrent aneurysm after coil only (n = 1) or after TriSpan-assisted embolization (n = 2), aneurysm remnant after clipping (n = 1), and aneurysm incidentally found in = 1). Procedural and clinical complications were recorded. Follow-up angiography was performed, and clinical outcomes were assessed by using the modified Rankin Scale score. 
RESULTS: TriSpan-assisted embolization was successful in 15/16 (93.8\%) procedures, with complete occlusion in 2/16 (12.5\%), near-complete occlusion in 10/16 (62.5\%), and incomplete occlusion in 3/16 (18.75\%). There were 6 (37.5\%) intraprocedural complications: thrombus formation (n = 3), protrusion of a TriSpan loop in the parent artery (n = 1), TriSpan displacement in the aneurysm (n = 1), and tangling of a coil loop in the device (n = 1). Three patients died in the hospital (21.4\%). Follow-up angiography or MR angiography was available in 8 (57.1\%) patients and showed complete (n 2), near-complete (n = 2), and incomplete occlusion (n = 4). Long-term clinical outcome was no (n = 4) or minor symptoms (n = 1) and moderate (n 2), moderately severe (n = 2), or severe handicap (n 2). 
CONCLUSION: The use of the TriSpan device is feasible in the anterior circulation and can assist treatment of difficult wide-neck bifurcation aneurysms.},
  author       = {DE KEUKELEIRE, KATRIEN and Vanlangenhove, Peter and Defreyne, Luc},
  issn         = {0195-6108},
  journal      = {AMERICAN JOURNAL OF NEURORADIOLOGY},
  keyword      = {MICROCATHETER,EMBOLIZATION,RECONSTRUCTION,BALLOON,BIFURCATION ANEURYSMS,CEREBRAL ANEURYSMS,RUPTURED INTRACRANIAL ANEURYSMS,GUGLIELMI DETACHABLE COILS},
  language     = {eng},
  number       = {1},
  pages        = {73--78},
  title        = {Evaluation of a neck-bridge device to assist endovascular treatment of wide-neck aneurysms of the anterior circulation},
  url          = {http://dx.doi.org/10.3174/ajnr.A0767},
  volume       = {29},
  year         = {2008},
}

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