Stepwise stent deployment technique for tandem intracranial aneurysms: a review of 21 cases

Objectives We performed this study to report our experience using a stepwise stent deployment technique for the treatment of tandem intracranial aneurysms. Methods Patients with intracranial tandem aneurysms that were treated with a stepwise stent deployment technique between May 2009 and June 2013 were retrospectively reviewed. Results Twenty-one patients with 42 tandem aneurysms were identified (11 men, 10 women), with a mean age of 53.7 years (range, 17-82 years). Subarachnoid haemorrhage was confirmed in 12 patients using computed tomography at onset. Complete occlusion was achieved in 20 of the aneurysms (47.6 %) after the procedure, neck remnant in 9 (21.4 %), and aneurysm remnant in 13 (31.0 %). The perioperative complications included in-stent thrombosis in one case and vasospasm in two cases, none of which left a permanent neurological deficit. The modified Rankin Scale (mRS) score at discharge was 0-2 in 20 cases and 3 in one case. The follow-up angiograms available for 17 patients showed complete occlusion in 26 aneurysms, improved in 4, and stable in 4. All of the patients had mRS scores of 0-1 during the clinical follow-up period. Conclusions The stepwise stent deployment technique is feasible and helpful in the treatment of intracranial tandem aneurysms.