[New trends in the treatment of bifurcation aneurysms]. / Neue Trends zur Behandlung von Bifurkationsaneurysmen.

CLINICAL ISSUE: Intracranial aneurysms most commonly occur at bifurcation sites. In case of dealing with broad based aneurysms, the risk of accidental vessel occlusion during embolization should not be underestimated. Therefore, several devices are available, e.g. WEB device and barrelsStent. Besides that, a special technique gives the opportunity to place two stents into each other or next to each other into both branches of a bifurcation. Over 300 patients included in 18 studies were treated with Y­stenting (e.g., Medline/Embase) showing a good clinical outcome in 92%. A complete occlusion was achieved in 91%. The rate of neurologic deficits was 4%, the procedure-caused mortality was 2%. Furthermore, 12% of the patients sustained a stroke during the intervention. Ruptured aneurysm was found in 19%. CONCLUSION: All in all, a high occlusion rate and a low rate of mortality and stroke were shown by using Y­stenting.