Objective Balloon-assisted coil embolization has become an important adjunct in the endovascular treatment of intracranial aneurysms, particularly those with challenging anatomy. The need for anti-platelet agents when deploying intracranial stents, which could lead to increased morbidity and mortality in patients with ruptured aneurysm, has made the use of balloon-assisted coil embolization (BACE) a more prevalent approach in the last several years for subarachnoid haemorrhage. We evaluated the safety and efficacy of balloon remodeling at our institute.
Methods We performed a retrospective review of all patients who underwent endovascular coiling of aneurysms from June 2012 to February 2014.
Results A total of 81 procedures were performed on 73 patients and 74 aneurysms were treated at our institution with endovascular techniques. 45 of 74 (60.81%) were ruptured aneurysms and venticulostomy was required in 31 (68.8%) of these patients. Balloon remodeling was used in 44 of 74(59.4%) of cases. More than 1 aneurysm were treated in the same procedure in 7 cases. 4 aneurysms were treated in 2 stages while 1 aneurysm required 3 stages for treatment. The following adverse events occurred: Thrombus formation 5/44 (11.3%); Vessel perforation from balloon 0/44 (0%); Perforation by coil occurred in 5/44 (11.3%) of cases. Dissection 0/44 (0%) and stroke related to thrombus formation 0/44 (0%). 4 out of 5 thrombi were formed in ruptured aneurysms. Balloon inflation time ranged from 1–5 min. Balloon inflation time did not correlate to thrombus formation. Neck diameters treated with balloons measured from 1.5 mm to 7.83 mm.
Conclusions In our single-center study, balloon-assisted coiling was not associated with serious complications. Minimal intra-operative thrombi which were formed resolved with almost no adverse events in patient. Further studies will need to be performed on long term outcomes of these patients, however, balloon-assisted coiling has emerged as an important adjunct in the endovascular treatment of aneurysms.
Disclosures V. Ramakrishnan: None. S. Quadri: None. A. Sodhi: None. V. Cortez: None. M. Taqi: None.
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