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Original research
Balloon-assisted coil embolization of intracranial aneurysms is not associated with increased periprocedural complications
  1. Alejandro Santillan1,
  2. Y Pierre Gobin1,
  3. Jan C Mazura1,
  4. Valerie Meausoone1,
  5. Lewis Z Leng1,
  6. Edward Greenberg1,
  7. Howard A Riina2,
  8. Athos Patsalides1
  1. 1Division of Interventional Neuroradiology, Department of Neurological Surgery, New York Presbyterian Hospital, Weill Cornell Medical Center, New York, New York, USA
  2. 2Department of Neurosurgery, New York University Langone Medical Center, New York, New York, USA
  1. Correspondence to Dr Alejandro Santillan, 525 E. 68th St, Division of Interventional Neuroradiology, Department of Neurosurgery, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY 10065, USA; als2052{at}


Background The balloon-assisted coil embolization (BACE) technique represents an effective tool for the treatment of complex wide-necked intracranial aneurysms; however, its safety is a matter of debate. This study presents the authors' institutional experience regarding the safety of the BACE technique.

Methods 428 consecutive patients with 491 intracranial aneurysms (274 acutely ruptured and 217 unruptured) treated with conventional coil embolization (CCE) or with BACE were retrospectively reviewed. All procedure-related adverse events were reported, regardless of clinical outcome. Thromboembolic events, intraprocedural aneurysm ruptures, device-related complications, morbidity and mortality were compared between the CCE and BACE groups.

Results The total rate of procedural and periprocedural adverse events was 9.6% (47/491 embolizations). Thromboembolic events, intraprocedural aneurysmal rupture and device-related complications occurred in 2.4%, 3.9% and 3.3% of procedures, respectively. The risk of thromboembolic events and device-related problems was similar between the CCE and BACE groups. A trend towards a higher risk of intraprocedural aneurysm rupture was observed in the BACE group (not statistically significant). The total cumulative morbidity and mortality for both groups was 2.6% (11/428 patients) and there was no statistically significant difference in the morbidity, mortality and cumulative morbidity and mortality rates between the two groups.

Conclusion In this series of patients with acutely ruptured and unruptured aneurysms, the BACE technique allowed treatment of aneurysms with unfavorable anatomic characteristics without increasing the incidence of procedural complications.

  • Balloon-assisted technique
  • coil embolization
  • intracranial aneurysm
  • morbidity
  • mortality
  • aneurysm
  • angiography
  • angioplasty
  • arteriovenous malformation
  • coil
  • drug
  • subarachnoid
  • stroke
  • blood pressure

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  • Competing interests None.

  • Ethics approval The study was approved by the ethics committee of New York Presbyterian Hospital/Weill Cornell Medical Center.

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