Initial single centre experience with Barrel VRD stent in large neck aneurisms

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Cristian Mihalea
Felicia Otilia Humulescu
Hazem Abdelkhalek
Sorin Pescariu
Bogdan Valeriu Popa
Horia Ples

Abstract

Introduction. Despite the use of new techniques, such as Y-stenting, the waffle-cone technique and intrasaccular flow disrupters the treatment of wide-neck bifurcation aneurysms is still challenging, especially for those where adjacent branches are arising at the neck level. Moreover, the use of flow diverter stents in bifurcation aneurysms has been proposed by several teams, although the results remain controversial.
This study is reflecting initial experience in our department with a relatively new device available on the market: Barrel VRD stent. The unique design feature of the device is the “belly-like” central part of the stent which protects the adjacent branches.
Methods. We retrospectively reviewed all patients in whom stenting with braided or laser-cut stents had been performed in our center. Three patients were identified and analyzed. Technical success, complications, immediate angiographic outcomes, procedural data, are reported here.
Results. One MCA bifurcation and two basilar tip large neck aneurysms with one branch arising from the neck level have been identified. Technical success was achieved in all procedures. Overall procedure-related morbidity and mortality was 0%. In the immediate post-treatment angiography, adequate occlusion (neck remnant or total occlusion) was observed in all patients. Short- and mild-term follow-up angiography showed adequate occlusion of the aneurysms.
Conclusions. In this small case series, retrospective single-center analysis we showed that Barrel VRD - stent assisted coiling is a safe and feasible technique. Moreover, it offers an elegant and effective endovascular solution for large neck basilar tip aneurysms on which the neurosurgical clipping remains challenging.

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How to Cite
Mihalea, C., Humulescu, F., Abdelkhalek, H., Pescariu, S., Popa, B., & Ples, H. (2019). Initial single centre experience with Barrel VRD stent in large neck aneurisms. Romanian Neurosurgery, 33(2), 127-134. https://doi.org/10.33962/roneuro-2019-025
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Author Biographies

Cristian Mihalea

Department of Neurosurgery, “Victor Babes” University of Medicine and Pharmacy, Timisoara, ROMANIA

Department of Interventional Neuroradiology, NEURI Brain Vascular Center, Bicêtre Hospital, Le Kremlin-Bicêtre, FRANCE

Felicia Otilia Humulescu

Bucharest University of Economic Studies, Faculty of Cybernetics, Statistics and Economic Informatics, ROMANIA

Bucharest University of Medicine and Pharmacy Faculty, Faculty of Dental Medicine, ROMANIA

Hazem Abdelkhalek

Department of Neurosurgery, “Victor Babes” University of Medicine and Pharmacy, Timisoara, ROMANIA

Department of Neuropsychiatry, Tanta University Hospital, Tanta, EGYPT

Sorin Pescariu

Cardiology Department, “Victor-Babes” University of Medicine and Pharmacy, Timisoara, ROMANIA

Bogdan Valeriu Popa

Department of Radiology and Medical Imaging, “Floreasca” Clinical Emergency Hospital, “Carol Davila” University of Medicine and Pharmacy, Bucharest, ROMANIA

Horia Ples

Department of Neurosurgery, “Victor Babes” University of Medicine and Pharmacy, Timisoara, ROMANIA