Hybrid y stenting with the waffle-cone. A technical note.

Limbucci, Nicola; Nappini, Sergio; Renieri, Leonardo; Consoli, Arturo; Rosi, Andrea; Grillea, Giovanni; Bartolo, Marcello; Mangiafico, Salvatore

Endovascular treatment of wide-neck bifurcation aneurysms is challenging and often requires adjunctive techniques and devices. We report our experience with the hybrid Y stenting with the waffle-cone technique, combining Y stent-assisted coiling and waffle-cone stenting techniques. This approach has been described only in a single case report using a combination of open and closed cell stents. We describe four cases treated by hybrid Y stenting with the waffle-cone procedure with a variation from the originally reported technique, consisting in deploying two closed cell stents. All patients were successfully treated without complications. We propose hybrid Y stenting with the waffle-cone for the treatment of wide-neck bifurcation aneurysms as a bailout technique after failure of Y stent-assisted coiling.