Semi-jailing technique for coil embolization of complex, wide-necked intracranial aneurysms

UMMS Affiliation

Department of Radiology

Faculty Mentor

Alexei Bogdanov

Publication Date


Document Type



Adult; Aged; Aspirin; *Blood Vessel Prosthesis; Cerebral Angiography; Embolization, Therapeutic; Female; Humans; Intracranial Aneurysm; Male; Microsurgery; Middle Aged; Platelet Aggregation Inhibitors; Prosthesis Design; *Stents; Ticlopidine; Treatment Outcome


Neurology | Radiology


OBJECTIVE: Stent-assisted coiling of intracranial aneurysms is performed by placing a microcatheter through a stent's interstices or jailing the microcatheter between the stent and the artery. Both approaches impede manipulation of the microcatheter during coiling. We describe a modified jailing technique that improves catheter maneuverability and report the safety and efficacy of the method for the treatment of complex, wide-necked aneurysms.

METHODS: The semi-jailing technique involves the partial deployment of a retrievable stent, bridging part of the aneurysm neck while leaving space to maneuver the microcatheter. Twenty-two complex, wide-necked aneurysms, including 3 ruptured and 5 dissecting, were treated using the semi-jailing technique (15 women; mean age, 55.2 years).

RESULTS: The semi-jailing technique was successfully applied in all cases. Immediate posttreatment angiograms showed total occlusion of the aneurysm in 17 cases (77%), neck remnant in 3 cases (14%), and aneurysm dome filling in 2 cases (9%). Follow-up angiography available in 10 patients at an average of 8.5 months showed progressive occlusion in 1 aneurysm and 7 remained occluded. In 2 cases of dissecting aneurysms, retreatment was required. No permanent periprocedural morbidity was encountered. One patient died of complications secondary to intracranial hemorrhage 6 days after treatment. In 2 cases (9%), thromboembolic events after final stent placement were successfully treated with intraarterial thrombolysis. No delayed stent migration was seen.

CONCLUSION: Semi-jailing is a safe and effective stent-assisted coiling technique that facilitates treatment of complex, wide-necked aneurysms.

DOI of Published Version



Neurosurgery. 2009 Dec;65(6):1131-8; discussion 1138-9. doi: 10.1227/01.NEU.0000356983.23189.16. Link to article on publisher's site

Journal/Book/Conference Title



Medical student Michael DeLeo participated in this study as part of the Senior Scholars research program at the University of Massachusetts Medical School.

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Link to Article in PubMed

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