Aneurysm occlusion with microcoils is an effective and safe procedure. However, bifurcation aneurysms usually have a wide neck, and their occlusion is still a difficult objective.
OBJECTIVE
To evaluate the efficacy and safety of bifurcation stents in the treatment of basilar bifurcation aneurysms.
MATERIAL AND METHODS
A retrospective analysis included 34 patients with basilar bifurcation aneurysms between 2016 and 2022. The pConus bifurcation stent was used as a stent-assistance for endovascular occlusion of aneurysms with microcoils. We analyzed technical features of stent implantation and clinical results of endovascular treatment. Mean aneurysm dimension was 8.4 mm, neck size — 4.6 mm. Preoperative MSR score 0-2 was observed in 94.7% of patients, 3—5 scores — in 5.3% of patients.
RESULTS
There were no significant changes in functional status early after surgery (MSR grading system). Total aneurysm occlusion was achieved in 67.6% of patients, subtotal — 17.6% of cases, partial — 14.8%. There were no technical or early postoperative clinical complications. Six months after surgery, total occlusion was observed in 77.8% of patients, subtotal occlusion — 14.8%, partial occlusion — 4%. MSR score 0—2 was observed between 3 and 12 months after surgery. One patient died from other cause rather aneurysm. Redo intervention due to aneurysm recanalization was performed in 1 patient.
CONCLUSION
The pConus bifurcation stent is effective and safe in endovascular treatment of basilar bifurcation aneurysms of the most complex configuration. There was a minimal risk of aneurysm recanalization in long-term postoperative period.