Solitaire ab

All enrolled patients were selected according to stroke guidelines and underwent EVT under local anesthesia by two neurointerventionists with 10 years of experience. EVT was performed using stent retrievers [Solitaire AB (Covidien/ev3, Irvine, United States) and Solitaire FR (Covidien/ev3, Irvine, United States)] or react suction devices (Covidien/ev3, Irvine, United States). The physician performing the neurointervention regularly reported the number of stent retriever passes. If targeted arterial recanalisation failed, rescue therapies such as stent implantation, balloon angioplasty, intracatheter tirofiban administration or intra-arterial thrombolysis would be used.

Three patients with intracranial bifurcation aneurysms, treated with stent-assisted coiling in real life, were included in this study. In case 1, a 66-year-old male with an unruptured small anterior communicating artery aneurysm (maximal diameter: 4.8 mm; width: 2.53 mm) was treated with a Neuroform (Stryker, Kalamazoo, Michigan, USA; size: 2.5 × 15mm) stent-assisted coiling embolization. For case 2, a 48-year-old female with a ruptured anterior communicating artery aneurysm (maximal diameter: 5.49 mm; width: 4.09 mm) was treated with LVIS (MicroVention, Tustin, CA, USA; size: 2.5 × 17mm) stent-assisted coiling. For case 3, a 57-year-old female with an unruptured A2/3 bifurcation aneurysm (maximal diameter: 6.96 mm; width: 7.22 mm) was treated with Solitaire AB (Covidien, Irvine, California; size: 4 × 20 mm) stent-assisted coiling embolization.
3D rotational angiographic images were obtained, while 3D segmentation and isolation of the region of interest were performed through the open-source software VMTK (www.vmtk.org). The segmented geometry before treatment is shown in Figure 1. To simplify the simulation of stenting, part of the adjacent parent artery with the aneurysm sac was isolated from the whole parent vessel using the Geomagic tool (Geomagic Inc., Morrisville, North Carolina). Our institutional review board approved this retrospective study with consent waived.

Coiling was performed through a 0.017-in. SL-10 microcatheter (Stryker, Kalamazoo, MI, USA). In all BAC procedures, Sceptre balloons (Microvention/Terumo, Aliso Viejo, CA, USA) were used.
For SAC, single-stenting or Y- and T-stenting techniques were used. Stent types implanted were Solitaire AB (Covidien, Irvine, CA, USA), Neuroform EZ and Atlas (Stryker, Kalamazoo, MI, USA), LEO Baby (Balt, Montmorency, France) or LVIS Jr. (Microvention/Terumo, Aliso Viejo, CA, USA).
In one case, the eCLIPs (Endovascular Clip System; Evasc Medical Systems Corp., Vancouver, BC, Canada) device was used to reconstruct the neck.

All patients underwent the treatment under local infiltration anesthesia combined with intravenous sedation. The patient was staying in a supine position, and the femoral vein under the right groin was usually the puncture point. After successful puncture, a 0.014 inch Floppy micro-guide wire (Stryker Corp, Kalamazoo, MI, USA) was inserted, and then a Rebar (18 or 27) (Covidien, St. Louis, MO, USA) micro-catheter was inserted under the guide wire. Contrast agent was injected to understand the thrombus and distal blood vessels. The Solitaire AB (Covidien, St. Louis, MO, USA) stent was used to enter the thrombus site through the microcatheter, the thrombus was fully embedded in the mesh of the stent and fixed, and the stent was withdrawn from the body together with the microcatheter.