• M Travis Caton, Alexander Z Copelan, Kazim H Narsinh, Amanda Baker, Adib A Abla, Randall T Higashida, Matthew R Amans, Steven W Hetts, and Daniel L Cooke.
• Department of Neurointerventional Radiology, University of California San Francisco, San Francisco, California, USA. Electronic address: Michael.caton2@ucsf.edu.
• World Neurosurg. 2021 Jul 1; 151: e363-e371.

BackgroundStent-assisted coil embolization of wide-necked bifurcation aneurysms often employs a Y configuration stent. A similar stent configuration, termed kissing/double-barrel (KDB), is used often at the aortoiliac bifurcation. Studies of KDB stents in aortoiliac disease show that rates of thromboembolic complications vary with the cross-sectional geometry of the stent pair, a function of the radial crush resistive force of each stent. We assessed cross-sectional geometry of intracranial stent pairs in an in vitro model of the basilar artery using flat-panel computed tomography.MethodsIn a silicone model of a wide-necked basilar tip aneurysm, 6 simulated KDB stent deployment trials were performed using combinations of 5 stents (Enterprise 1, Enterprise 2, Neuroform Atlas, LVIS, LVIS Jr.). Flat-panel computed tomography reconstructions were used to assess cross-sectional stent geometry. Relative conformability, defined by ovalization and D-ratio, radial crush resistive force (predicted vs. actual), and radial mismatch fraction were compared by stent type (braided vs. laser-cut).ResultsSeveral distinct forms of cross-sectional stent geometry were observed. Braided stents had lower ovalization and D-ratio (P = 0.015) than laser-cut stents. The Neuroform Atlas/LVIS combination yielded the lowest radial mismatch fraction (19.7% vs. mean 44.3% ± 0.7%). Braided stents tended to have a deployed stent radius closer to the expected (nominal) diameter (i.e., higher relative crush resistive force) than laser-cut stents (measured vs. nominal diameter discrepancy +38.6% ± 21.1% vs. -10.7% ±16.1%, P = 0.14).ConclusionsIn constant anatomy, cross-sectional geometry of the KDB stent configuration will vary depending on the design and structure of the stents employed.Copyright © 2021 The Author(s). Published by Elsevier Inc. All rights reserved.

21 keywords...

hide…