Waffle Y technique: pCONus for tandem bifurcation aneurysms of the middle cerebral artery

Journal of Neurointerventional Surgery
Anastasios MpotsarisWerner Weber

Abstract

Broad based bifurcation aneurysms are challenging. Various endovascular techniques aim at stabilizing the coil package in the aneurysm. Among these, the waffle cone technique provides a viable alternative to Y stenting in selected cases, incorporating a less complex delivery, and the reduced inherent risk of a single stenting procedure compared with the use of two stents in Y configuration. Unlike conventional stents, the distal end of the new pCONus device opens like a blossoming flower inside of the aneurysm to facilitate the waffle cone technique. In a case with tandem unruptured broad based middle cerebral artery bifurcation aneurysms, the complex anatomical challenge was resolved by a unique combination of both techniques: two pCONus deployed in Y configuration, offering stable neck coverage for coiling both aneurysms. The angiographic results with complete occlusion of both aneurysms and the uneventful clinical course at 90 days with continued daily administration of dual antiplatelet therapy are encouraging.

References

Nov 11, 2008·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·Tzu Hsien YangTzu Lung Ho
Feb 11, 2012·Journal of Korean Neurosurgical Society·Jun-Sung Cho, Young-Joon Kim
Mar 24, 2012·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·W LiuD M Hasan
Jun 28, 2012·Journal of Korean Neurosurgical Society·Hye-Ran ParkSung-Ho Kim
Mar 16, 2013·Surgical Neurology International·David J PadalinoEric M Deshaies

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Citations

Feb 26, 2016·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Zhi-Gang YangBo Hong
Dec 17, 2014·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·Nicola LimbucciSalvatore Mangiafico
Sep 9, 2015·Journal of Neurointerventional Surgery·Boris LubiczOmer Faruk Eker
May 13, 2015·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·Omer Fatih NasBahattin Hakyemez
Jun 21, 2015·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·Shih-Min LeeJung Ho Ko
Jan 4, 2018·Journal of Clinical Imaging Science·Krishna Prasad Bellam PremnathAnil Kumar Shivan
Dec 25, 2015·Journal of Neurointerventional Surgery·Marta Aguilar PérezVitor Mendes Pereira
Aug 23, 2017·Journal of Clinical Imaging Science·Krishna Prasad Bellam PremnathAnil Kumar Shivan

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