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

Neurosurgery. 2009 Dec;65(6):1131-8; discussion 1138-9. doi: 10.1227/01.NEU.0000356983.23189.16.


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.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Aspirin / therapeutic use
  • Blood Vessel Prosthesis*
  • Cerebral Angiography / methods
  • Clopidogrel
  • Embolization, Therapeutic / instrumentation*
  • Embolization, Therapeutic / methods*
  • Female
  • Humans
  • Intracranial Aneurysm / pathology
  • Intracranial Aneurysm / therapy*
  • Male
  • Microsurgery
  • Middle Aged
  • Platelet Aggregation Inhibitors / therapeutic use
  • Prosthesis Design
  • Stents*
  • Ticlopidine / analogs & derivatives
  • Ticlopidine / therapeutic use
  • Treatment Outcome


  • Platelet Aggregation Inhibitors
  • Clopidogrel
  • Ticlopidine
  • Aspirin