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E-045 Balloon-assisted coiling of cerebral aneurysms with the dual lumen scepter XC balloon catheter: experience at two high volume centers
  1. A Wallace1,
  2. E Samaniego2,
  3. Y Kayan1,
  4. C Derdeyn3,
  5. J Delgado1,
  6. B Zheng4,
  7. J Fease1,
  8. M Thomas1,
  9. J Scholz1,
  10. A Milner1,
  11. S Ortega2
  1. 1NeuroInterventional Radiology, Abbott Northwestern Hospital, Minneapolis, MN
  2. 2Neurology, University of Iowa, Iowa City, IA
  3. 3Radiology, Univeristy of Iowa, Iowa City, IA
  4. 4Neurology, Abbott Northwestern Hospital, Iowa City, IA

Abstract

Introduction Balloon-assisted coiling (BAC) is a well-established technique for treatment of wide-necked cerebral aneurysms. The Scepter XC (Microvention, Tustin, California, USA) is a dual-lumen balloon catheter that can be used for aneurysm-neck remodeling, protection of branch vessels arising from or near the aneurysm neck, and stabilization of the microcatheter during coil deployment. The lumen also accommodates a 0.014 inch microwire. We describe our initial experience with the use of this device for BAC of cerebral aneurysms.

Methods Two high-volume institution neurointerventional databases were retrospectively reviewed for cerebral aneurysms treated with BAC using the Scepter XC balloon catheter. Wide-neck aneurysms were defined as those with a neck width ≥4 mm or a dome-to-neck ratio <2 measured on digital subtraction angiography (DSA). Patient demographics, aneurysm characteristics, and procedural details were recorded. Follow-up occlusion status was assessed with time-of-flight MRA for aneurysms <10 mm, MRA with and without gadolinium contrast for aneurysms >10 mm, or DSA and rated using the Raymond-Roy classification.

Results During the study period, 231 aneurysms were treated in 219 patients (152 women, 67 men) with a mean age of 58.4±12.2 years. Mean aneurysm size was 6.1±3.1 mm, with a mean neck diameter of 3.1±1.3 mm. 77.9% (180/231) of aneurysms were wide-necked, and 39.8% (92/231) were acutely ruptured at the time of treatment. The overall complication rate was 12.1% (28/231) per treated aneurysm, including a 4.8% (11/231) rate of symptomatic thromboembolic events, 8.6% (8/92) rate of intraoperative rupture when treating acutely ruptured aneurysms, and 1.4% (2/139) rate of intraoperative aneurysm rupture in elective cases. Excluding patients who died, DSA or MRA follow up was available for 85.3% (191/224) of aneurysms. During a mean follow-up of 17.4±13.0 months (range, 1.7–66.5 months), Raymond-Roy 1oc and 2oc clusion rates were 56.5% (108/191) and 35.6% (68/191), respectively. The retreatment rate was 13% (24/191).

Conclusions Balloon-assisted coiling using the dual coaxial lumen Scepter XC demonstrates acceptable aneurysm occlusion and complication rates.

Disclosures A. Wallace: None. E. Samaniego: 2; C; Medtronic, Microvention. Y. Kayan: 2; C; Medtronic, Penumbra, Microvention. C. Derdeyn: None. J. Delgado: 2; C; Medtronic, Penumbra, Microvention, Accriva. B. Zheng: None. J. Fease: None. M. Thomas: None. J. Scholz: None. A. Milner:None. S. Ortega: 2; C; Stryker Neurovascular, Medtronic.

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