T-Stent or Half T-Stent-Assisted Embolization of Wide-Necked Aneurysms at the Internal Carotid-Posterior Communicating Artery Bifurcation

Abstract

Objective: We report the usefulness and pitfalls of coil embolization using the T or half T-stent technique for aneurysms located at internal carotid artery-posterior communicating artery (ICA-P-com) bifurcation in which the neck is wide and the P-com must be kept patent due to it being the fetal-type with a hypoplastic P1 segment.

Case Presentations: Two cases were treated using the T-stent technique and two were treated using the half T-stent technique. The average age of the patients was 70.3 years and all were females. One aneurysm ruptured. The average size of aneurysms and neck was 12 mm and 8.5 mm, respectively, in the T-stent group, and 7.4 mm and 6.7 mm, respectively, in the half T-stent group. An S- or pigtail-shaped microcatheter (MC) was used to navigate into the P-com. Stent deployment was successful in all the cases. Retreatment was required in one case treated using the T-stent technique due to major recurrence.

Conclusion: T or half T-stent-assisted coil embolization can be an alternative endovascular treatment method for wide-necked ICA-P-com aneurysms in which the P-com must be kept patent due to it being the fetal-type with a hypoplastic P1 segment.