Double-stent method: therapeutic alternative for small wide-necked aneurysms

Technical note

Arnd Doerfler Department of Neuroradiology, Institute of Diagnostic and Interventional Radiology; and Department of Neurosurgery, University of Essen Medical School, Essen, Germany

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Isabel Wanke Department of Neuroradiology, Institute of Diagnostic and Interventional Radiology; and Department of Neurosurgery, University of Essen Medical School, Essen, Germany

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Thomas Egelhof Department of Neuroradiology, Institute of Diagnostic and Interventional Radiology; and Department of Neurosurgery, University of Essen Medical School, Essen, Germany

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Dietmar Stolke Department of Neuroradiology, Institute of Diagnostic and Interventional Radiology; and Department of Neurosurgery, University of Essen Medical School, Essen, Germany

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Michael Forsting Department of Neuroradiology, Institute of Diagnostic and Interventional Radiology; and Department of Neurosurgery, University of Essen Medical School, Essen, Germany

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✓ The authors present two cases of patients with small, acutely ruptured, wide-necked aneurysms of the distal vertebral artery that were not amenable to conventional coil embolization and were instead treated by means of a double-stent method in which one stent was placed inside another. Angiography performed immediately after the procedure revealed a significant reduction in aneurysm filling; total occlusion of the lesion was observed after 7 days and confirmed 6 months later in both aneurysms. By placing one stent inside the other, stent permeability can be reduced, which may result in significant hemodynamic changes with accelerated aneurysm thrombosis. This double-stent method may represent a therapeutic alternative, especially in cases of small, wide-necked aneurysms in which conventional endovascular techniques or stent-supported coil embolization is not considered feasible or is believed to be too dangerous, and surgical treatment is contraindicated.

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