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The impact of stent design on the structural mechanics of the crossing Y-stent: an in vitro study

  • Interventional Neuroradiology
  • Published:
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Abstract

Introduction

Crossing Y-stent technique is a valid option for coiling wide-necked bifurcation aneurysms. Two main designs of stents, the closed- (CCS) and open-cell (OCS), are used in combination for a crossing Y-construct. This in vitro study was conducted to assess the mechanical characteristics of each stent-combination and to suggest an optimal combination for clinical practice.

Methods

The Enterprise and the Neuroform3 stents were used as closed-cell and open-cell stents, respectively. Four different Y-stent combinations; double CCSs (CCS-CCS; Enterprise-Enterprise), OCS followed by CCS (OCS-CCS; Neuroform-Enterprise), CCS followed by OCS (CCS-OCS; Enterprise-Neuroform), and double OCSs (OCS-OCS; Neuroform-Neuroform) were tested in a bifurcation aneurysm model. Images of the model were obtained by digital subtraction angiography (DSA), and morphological changes of Y-constructs caused by interaction between stents were compared.

Results

Double OCSs showed the best stent apposition to model branches and no collapse of the second stent at the intersection, whereas Y-stent combinations using a CCS as the second stent showed tubular collapse of the second stent at the crossing point. These combinations revealed unsatisfactory apposition to the model branch in which the second stent was deployed. Most narrowing of the second stent was noted in the double CCSs construct, which resulted in poorest stent apposition.

Conclusion

Based on a simple in vitro experiment, we suggest that double OCSs Y-construct is optimal for achieving best stent-wall apposition. Furthermore, our findings suggest that Y-stent combinations utilizing a CCS as the second stent may increase the risk of thromboembolic complications due to poor stent-wall apposition.

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We declare that this manuscript does not contain clinical studies or patient data.

Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Neurosurgery, Keimyung University School of Medicine, 56 Dalseong-ro, Jung-gu, Daegu, 700-712, Republic of Korea

    Chang-Young Lee, Seong-Ho Park & Chang-Hyun Kim

  2. Department of Radiology, Baylor College of Medicine, Houston, TX, USA

    Goetz Benndorf

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  1. Chang-Young Lee
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  2. Seong-Ho Park
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  3. Chang-Hyun Kim
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  4. Goetz Benndorf
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Correspondence to Chang-Young Lee.

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Lee, CY., Park, SH., Kim, CH. et al. The impact of stent design on the structural mechanics of the crossing Y-stent: an in vitro study. Neuroradiology 56, 655–659 (2014). https://doi.org/10.1007/s00234-014-1378-3

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  • DOI: https://doi.org/10.1007/s00234-014-1378-3

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