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Original research
Balloon-assisted coil embolization and large stent delivery for cerebral aneurysms with a new generation of dual lumen balloons (Copernic 2L)
  1. Adrien Guenego1,2,
  2. Jean-Baptiste Zerlauth3,
  3. Francesco Puccinelli2,
  4. Steven Hajdu2,
  5. David C Rotzinger2,
  6. Felix Zibold4,
  7. Eike I Piechowiak4,
  8. Pasquale Mordasini4,
  9. Jan Gralla4,
  10. Tomas Dobrocky4,
  11. Roy T Daniel5,
  12. René Chapot6,
  13. Pascal J Mosimann2,4
  1. 1 Department of Interventional and Diagnostic Neuroradiology, Toulouse University Hospital, Toulouse, France
  2. 2 CHUV, Department of Interventional and Diagnostic Neuroradiology, University Hospital of Lausanne, Lausanne, Switzerland
  3. 3 Institute of Diagnostic and Interventional Neuroradiology, Cecil - Hirslanden Clinic, Lausanne, Switzerland
  4. 4 Department of Diagnostic and Interventional Neuroradiology, Inselspital - Bern University Hospital, Bern, Switzerland
  5. 5 CHUV, Department of Neurosurgery, University Hospital of Lausanne, Lausanne, Switzerland
  6. 6 Department of Neurointerventional Therapy, Krupp Krankenhaus, Essen, Germany
  1. Correspondence to Dr Pascal J Mosimann, Inselspital, Neuroradiology, Freiburgstrasse 10, Sahli Haus 1, 3010 Bern, Switzerland; pascal.mosimann{at}


Introduction Dual coaxial lumen balloon microcatheters through which small stents can be delivered have recently been described. We report a series of a new type of dual lumen balloon catheter with a parallel lumen design enabling enhanced inflation and deflation properties through which larger stents may be deployed, including flow diverters (FD).

Methods All aneurysms that were treated with a Copernic 2L (COP2L) dual lumen balloon catheter at our institution between February 2014 and December 2016 were assessed. Patient demographics, aneurysm characteristics, clinical and angiographic follow-up, as well as adverse events were analyzed.

Results A total of 18 aneurysms in 16 patients (14 women) were treated with the COP2L. Mean maximal aneurysm diameter was 6.4 mm, mean neck size was 3.3 mm (min 1; max 6.3), and mean aneurysm height/width was 1.1 (min 0.5; max 2.1). The COP2L was used for balloon-remodeled coiling exclusively in 2 aneurysms; coiling and FD stenting in 8; coiling and braided stent delivery in 3; coiling, braided and FD stenting in 1; and FD stenting without coiling in 4 (stenting alone). The rate of Roy–Raymond 1 (complete occlusion) changed from 22% in the immediate postoperative period to 100% at 3 months (mean imaging follow-up 8.2 months). There were three technical complications (3/16, 18.7%), including a perforation and two thromboembolic asymptomatic events that were rapidly controlled with the COP2L. There was no immediate or delayed morbidity or mortality (modified Rankin Scale score 0–1 in 100% of patients).

Conclusion The COP2L is a new type of dual lumen balloon catheter that may be useful for balloon and/or stent-assisted coiling of cerebral aneurysms. The same device can be used to deliver stents up to 4.5 mm and to optimize stent/wall apposition or serve as a life-saving tool in case of thromboembolic or hemorrhagic events. Long-term efficacy and safety need to be further assessed with larger case-controlled cohorts.

  • aneurysms
  • dual lumen balloon
  • large stent delivery
  • embolization
  • onyx

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  • Contributors Conception and design: PJM. Acquisition of data: PJM, FP, J-BZ, AG, SH. Analysis and interpretation of data: all authors. Drafting the article: AG and PJM. Critically revising the article: all authors. Reviewed submitted version of manuscript: all authors. Approved the final version of the manuscript on behalf of all authors: PJM.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests AG, J-BZ, FP, SH, DCR, JG, PJM, TD, FZ, EIP, RC and RTD report no disclosures relevant to the manuscript. PJM was a consultant and proctor for Balt Extrusion at the time of the manuscript preparation.

  • Provenance and peer review Not commissioned; externally peer reviewed.