Need for Y-stenting in stent-assisted coiling of wide-neck bifurcation aneurysms*

Background and Purpose: Stent-assisted coiling of wide neck bifurcation aneurysms in the anterior communicating segment and basilar tip region can be performed with varying stent configurations, including single stenting or Ystenting. Y-stenting requires two stents and thus incurs greater cost and procedural complexity than single-stent constructs. The influence of first stent type on the need for Y-stenting remains unknown. Materials and Methods: Clinical and angiographic data were retrospectively obtained for patients that underwent stent-assisted coiling for basilar tip or anterior communicating aneurysms at a high-volume center. Patients were included in this study if stent-assisted coiling was performed using Neuroform Atlas or LVIS Jr stents. A multivariate binary logistic regression was performed to measure the influence of first stent type on the need for Y-stenting. Results: Stent-assisted coiling was used to treat 82 aneurysms in 81 patients during the study period, and Ystenting was performed in 18.3% (15/82) of cases. In multivariate logistic regression analysis, use of LVIS Jr. as the first stent did not significantly influence the need for subsequent Y-stenting after controlling for aneurysm morphology (OR 0.65, 95% CI 0.18-2.43). Conclusion: Controlling for aneurysm morphology and location, the use of Y-stenting for stent-assisted coiling was not independently influenced by the choice of LVIS Jr or Neuroform Atlas as the first stent. A larger cohort may reveal differences between these two stents, particularly for aneurysms with large neck sizes.

Automated summary

The type of the first stent does not significantly influence the need for subsequent Y-stenting in stent-assisted coiling of wide neck bifurcation aneurysms in the anterior communicating segment and basilar tip region. A larger cohort may reveal differences between these two stents in aneurysms with large neck sizes.