INTRODUCTION: The objective of this study was to analyze the place for the balloon remodeling and stenting in the endovascular treatment of intracranial aneurysms as well as the impact of their use on the failure and complications rates. Analysis was conducted in a recent 3-year period (2008-2010) in a single center. METHODS: A total of 287 aneurysms, harbored by 252 patients (age, 16-87 years; mean, 50.9 ± 13.4 years), were proposed for endovascular treatment. Patient and aneurysms characteristics, modalities of treatment (coiling, remodeling, or stenting), failure rate, and rate of adverse events related to the treatment were analyzed. RESULTS: Treatment failed in 3/287 aneurysms (1.0%). The use of the remodeling technique and stenting increased over time (23.9% and 4.6% in 2008, 39.5% and 14.9% in 2009, and 43.9% and 20.7% in 2010, respectively). The remodeling technique was used in a similar percentage of cases independent of aneurysm characteristics (aneurysm status, location, and size, and neck size), except dome-to-neck ratio. Stenting was more frequently used in unruptured aneurysms, in internal carotid artery aneurysms, and in wide neck aneurysms. The rate of specific adverse events (thromboembolism and intraoperative rupture) was similar in coiling (2.8%), remodeling (6.9%), and stenting (1.1%). The rate of specific adverse events was similar in 2008, 2009, and 2010 (2.3%, 4.4%, and 6.1%, respectively). CONCLUSION: In the endovascular management of intracranial aneurysms, the large use of the remodeling technique combined with stenting in selected cases enables a low rate of treatment failures without increasing the rate of complications.
INTRODUCTION: The objective of this study was to analyze the place for the balloon remodeling and stenting in the endovascular treatment of intracranial aneurysms as well as the impact of their use on the failure and complications rates. Analysis was conducted in a recent 3-year period (2008-2010) in a single center. METHODS: A total of 287 aneurysms, harbored by 252 patients (age, 16-87 years; mean, 50.9 ± 13.4 years), were proposed for endovascular treatment. Patient and aneurysms characteristics, modalities of treatment (coiling, remodeling, or stenting), failure rate, and rate of adverse events related to the treatment were analyzed. RESULTS: Treatment failed in 3/287 aneurysms (1.0%). The use of the remodeling technique and stenting increased over time (23.9% and 4.6% in 2008, 39.5% and 14.9% in 2009, and 43.9% and 20.7% in 2010, respectively). The remodeling technique was used in a similar percentage of cases independent of aneurysm characteristics (aneurysm status, location, and size, and neck size), except dome-to-neck ratio. Stenting was more frequently used in unruptured aneurysms, in internal carotid artery aneurysms, and in wide neck aneurysms. The rate of specific adverse events (thromboembolism and intraoperative rupture) was similar in coiling (2.8%), remodeling (6.9%), and stenting (1.1%). The rate of specific adverse events was similar in 2008, 2009, and 2010 (2.3%, 4.4%, and 6.1%, respectively). CONCLUSION: In the endovascular management of intracranial aneurysms, the large use of the remodeling technique combined with stenting in selected cases enables a low rate of treatment failures without increasing the rate of complications.
Authors: A M Malek; V V Halbach; C C Phatouros; T E Lempert; P M Meyers; C F Dowd; R T Higashida Journal: Neurosurgery Date: 2000-06 Impact factor: 4.654
Authors: Alexandra Bandeira; Guy Raphaeli; Danielle Balériaux; Michael Bruneau; Olivier De Witte; Boris Lubicz Journal: Neuroradiology Date: 2009-10-13 Impact factor: 2.804
Authors: S Gallas; A C Januel; A Pasco; J Drouineau; J Gabrillargues; A Gaston; C Cognard; D Herbreteau Journal: AJNR Am J Neuroradiol Date: 2009-08-13 Impact factor: 3.825