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55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

Management of wide neck and fusiform aneurysms using ballon expandable stents: The overlapping stent technique: Stent in Stent

Management weithalsiger und fusiformer Aneurysmen mit ballonexpandierbaren überlappenden Stents: Stent in Stent

Meeting Abstract

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Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocDI.08.05

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Published: April 23, 2004

© 2004 Reul.
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Wide neck aneurysms and fusiform aneurysms are still difficult to treat. Several methods are discussed. We report our experiences in a number of cases using balloon expandable coronary stents, using an overlapping technique.


Eleven patients were treated during the last 15 months. All suffered from symptomatic aneurysms; three were located at the vertebral artery, four at the basilar artery, and four at the carotid artery. The patients with basilar aneurysms suffered from the mass effect of the fusiform giant aneurysms. The stents were placed in coaxial technique via a transfemoral approach. The size of the vessel was measured in a 3D rotational angiogram. The first stent was placed across the aneurysm from distal normal artery segment to proximal normal artery segment. A second shorter stent was placed in the inflow zone of the aneurysm. If the flow was not clearly reduced, a third stent was placed.


Immediately after the procedure, the inflow into the aneurysm was reduced, but not stopped. The follow-up after two months or later showed, in all cases, a complete occlusion of the aneurysm or a significant reduction of size and inflow. In two cases, a second procedure was performed to close the aneurysm. In one case the additional placement of coils was done. Using this strategy, all aneurysms could be treated successfully without any major complication. MRI and or Multislice-CT could demonstrate the reduction of the mass effect and the shrinking of the aneurysm.


In this small series however, we could demonstrate that wide necked and fusiform aneurysm could be treated using the overlapping stent technique. For futher development, flexible covered stents would be very helpful.