Stent-assisted Coil Embolization for Targeted Parent Artery Occlusion: A Technical Note “Parent Artery Occlusion Using Combined Coil and Stent: PACS Method”

Abstract

Objective: Endovascular parent artery occlusion (PAO) is a treatment option for complex cerebral aneurysms with the attendant risk of ischemic complications. In this article, we performed a novel PAO technique using both coils and a stent (PACS method) achieving targeted occlusion of parent artery with reduced risk of ischemic complications.

Case Presentations: We performed PAO for 3 patients with cerebral aneurysms harboring critical arterial branches adjacent to the occlusion site. First, we placed an open-cell stent at the targeted site. Then, a few initial coils were readily anchored and stabilized by the struts of the stent, resulting in targeted embolization with preservation of critical branches in a short time. Patients’ outcomes were favorable without ischemic complications.

Conclusion: The PACS method is useful in conjunction with PAO to avoid critical branch-perforator ischemia or when anchoring is challenging with coils alone.