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“Stent-Within-a-Stent Technique”: Nothing New Under the Sun
===============================================================

* G. Benndorf
* A. Campi

*Dear Editor:* We read with interest the report by Metha and colleagues regarding the use of a stent within a stent for the treatment of dissecting vertebral artery aneurysms (1). It would seem to have been appropriate for these authors to cite our earlier report regarding the use of this technique (2, 3).

Writing and publishing scientific papers is facilitated by the availability of modern electronic search tools such as Medline or Pubmed, as well as by on-line libraries, through which major journals are easily accessible. Statements regarding “first time” and “to our knowledge,” in our opinion, should be used only when full literature searches have been carried out.

Nonetheless, we congratulate the authors on their results and thank them for their contribution.

## References

1.  Metha B, Burke T, Kole M, Bydon A, Seyfried D, Malik G. **Stent-within-a-stent technique for the treatment of dissecting vertebral artery aneurysms.** AJNR Am J Neuroradiol 2003;24:1814–1818
    
    [Abstract/FREE Full Text](http://www.ajnr.org/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiYWpuciI7czo1OiJyZXNpZCI7czo5OiIyNC85LzE4MTQiO3M6NDoiYXRvbSI7czoyMToiL2FqbnIvMjUvNC82NjMuMi5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=) 

2.  Benndorf G, Herbon U, Sollmann WP, Campi A. **Treatment of a ruptured dissecting vertebral artery aneurysm with double stent placement: case report.** AJNR Am J Neuroradiol 2001;22:1844–1848
    
    [Abstract/FREE Full Text](http://www.ajnr.org/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiYWpuciI7czo1OiJyZXNpZCI7czoxMDoiMjIvMTAvMTg0NCI7czo0OiJhdG9tIjtzOjIxOiIvYWpuci8yNS80LzY2My4yLmF0b20iO31zOjg6ImZyYWdtZW50IjtzOjA6IiI7fQ==) 

3.  Benndorf G, Campi A, Schneider GH, et al. **Overlapping stents for treatment of a dissecting carotid artery aneurysm.** J Endovas Ther 2001;8:566–570
    
    [CrossRef](http://www.ajnr.org/lookup/external-ref?access_num=10.1583/1545-1550(2001)008<0566:OSFTOA>2.0.CO;2&link_type=DOI) 
    
    [PubMed](http://www.ajnr.org/lookup/external-ref?access_num=11797969&link_type=MED&atom=%2Fajnr%2F25%2F4%2F663.2.atom) 
    
    [Web of Science](http://www.ajnr.org/lookup/external-ref?access_num=000173089900005&link_type=ISI) 

#  {#article-title-2}

*Reply* 

We wish to offer our apology for not citing Dr. Benndorf and colleagues’ *AJNR* article in our literature review (1). Our experience with stent-within-stent, telescoping stents, or double-stent techniques for dissecting vertebral artery aneurysms is similar to the conclusions made in the 2001 case report. It often takes years for an article to make its way from a simple idea to a hypothesis, then a theory scrutinized at various levels and through multiple reviews, and finally into print. In the meantime, other articles may be in the publishing process and may never make it into the next article’s bibliography. It is an unfortunate reality that we all face.

This is such a rapidly evolving field that, as new devices become available, many centers independently and simultaneously achieve similar results. We are happy to contribute our case series to the growing body of literature and would like to thank Dr. Benndorf and colleagues for reminding us of his case report as well as others who have recently applied analogous stent-within-stent, telescoping, or double-stent techniques for dissecting-type aneurysms (2).

## Reference

1.  Benndorf G, Herbon U, Sollmann WP, Campi A. **Treatment of a ruptured dissecting vertebral artery aneurysm with double stent placement: case report.** AJNR Am J Neuroradiol 2001;22:1844–1848
    
    [Abstract/FREE Full Text](http://www.ajnr.org/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiYWpuciI7czo1OiJyZXNpZCI7czoxMDoiMjIvMTAvMTg0NCI7czo0OiJhdG9tIjtzOjIxOiIvYWpuci8yNS80LzY2My4yLmF0b20iO31zOjg6ImZyYWdtZW50IjtzOjA6IiI7fQ==) 

2.  MacKay CI, Han PP, Albuquerque FC, McDougall CG. **Recurrence of a vertebral artery dissecting pseudoaneurysm after successful stent-supported coil embolization: case report.** Neurosurgery 2003;53:754–761
    
    [PubMed](http://www.ajnr.org/lookup/external-ref?access_num=12943592&link_type=MED&atom=%2Fajnr%2F25%2F4%2F663.2.atom) 

*   Copyright © American Society of Neuroradiology