Use of Buddy Wire to Facilitate Y-Configured Stent Placement in Middle Cerebral Artery Bifurcation Aneurysms With Daughter Branches Arising From the Sac: A Technical Note

Abstract

BACKGROUND AND IMPORTANCE: Endovascular treatment of geometrically complex bifurcation aneurysms using a standard Y-configured stenting technique might be extremely difficult, particularly in aneurysms with daughter branches that acutely arise from the aneurysm sac itself. In those cases, deployment of the second stent through interstices of the first stent could be troublesome because of untoward angular changes in the vascular bifurcation prompted by angular changes resulting from placement of the first stent. Here, we describe a novel application of the buddy wire technique to facilitate Y-configured stenting in middle cerebral artery (MCA) bifurcation aneurysms with unfavorable anatomic configuration.