Reverse waffle cone technique in management of stent dislodgement into intracranial aneurysms

Chao Bao Luo*, Yen Jun Lai, Michael Mu Huo Teng, Feng Chi Chang, Chung Jung Lin, Wan Yuo Guo

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Stent-assisted coil embolization (SACE) is a common method to manage intracranial wide-neck aneurysm. Using this technique, a stent must be successfully deployed into the parent artery to cross the aneurysm neck. We describe the reverse waffle cone technique in management of intra-procedural stent dislodgement during SACE of internal carotid artery (ICA) wide-neck aneurysms. Two patients with unruptured wide-neck ICA aneurysms underwent SACE. Intra-procedural forward stent migration occurred during catheterization with proximal stent dislodgement and migration into the aneurysm sac. Navigation of a second stent to bridge the aneurysm neck failed in one patient because the second stent was impeded by the dislodged stent. Using the reverse waffle cone technique, a microcatheter was navigated into the aneurysm sacs. Coils were safely detached into each aneurysm sac without any device assistance. The two wide-neck aneurysms were successfully treated with preservation of flow to the internal carotid arteries. The complication of intra-procedural distal stent migration and dislodgement, with proximal stent prolapse into an aneurysm sac, may not result in a failure to coil the aneurysm. The reverse waffle cone technique provides an effective treatment in the management of this complication.

Original languageEnglish
Pages (from-to)1306-1308
Number of pages3
JournalJournal of Clinical Neuroscience
Volume20
Issue number9
DOIs
StatePublished - Sep 2013

Keywords

  • Complication
  • Endovascular embolization
  • Intracranial aneurysm
  • Stent

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