Aglaé Velasco González1,2, P Stracke3, H Nordmeyer3, M Heddier3, S Saleme4, C Sauerland5, S Berkemeyer6,7, B Buerke6, W Heindel6, R Chapot3. 1. Department of Neuroradiology, Alfried-Krupp Krankenhaus Hospital, Alfried-Krupp Straße 21, 45131, Essen, Germany. Aglae.VelascoGonzalez@ukmuenster.de. 2. Department of Clinical Radiology, Neuroradiology, University of Muenster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Muenster, Germany. Aglae.VelascoGonzalez@ukmuenster.de. 3. Department of Neuroradiology, Alfried-Krupp Krankenhaus Hospital, Alfried-Krupp Straße 21, 45131, Essen, Germany. 4. Department of Interventional Neuroradiology, Dupuytren University Hospital, 2 avenue Martin Luther-King, 87042, Limoges, France. 5. Department of Biostatistics and Clinical Investigation, University of Muenster, Schmeddingstraße 56, 48149, Muenster, Germany. 6. Department of Clinical Radiology, Neuroradiology, University of Muenster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Muenster, Germany. 7. Department of Community Health, Hochschule für Gesundheit, Gesundheitscampus 6-8, D-44801, Bochum, Germany.
Abstract
PURPOSE: In the treatment of wide-necked aneurysms, stenting may be required after balloon-assisted coiling (BAC) for reconstructing the lumen/flow of the parent artery in cases of coil herniation. The potential benefits and complications of both techniques remain unclear when used together. Our aim was to assess the safety and long-term angiographic outcomes of stenting after BAC. METHODS: Retrospective review of 87 unruptured wide necked aneurysms (in 80 patients) treated with BAC and requiring stent placement at the final stage of the procedure due to coil prolapse. Aneurysm characteristics, technical issues, clinical records, and MR results were assessed. Post-treatment and follow-up angiograms were evaluated by two independent reviewers and categorized as "stable," "further thrombosis," or "recanalization." RESULTS: The mean maximum diameter was 9.1 ± 4.7 mm and aspect ratio 1.20 ± 0.47. Complete and near-complete initial occlusion were observed in 53 (60.9%) and 28 (32.2%) of all treated aneurysms, respectively. Angiographic follow-up (80 aneurysms; mean, 34.68 ± 25.26 months) revealed stability and further thrombosis in 92.4% (74/80). Recanalization was observed in six cases (7.5%, 6/83), four of which were retreated. No significantly different outcomes were found in terms of aneurysm size (p = 0.641). Transient and reversible procedure-related complications occurred in eight (9.2%), minor permanent deficits in 2.3%, and major deficits, including death, in four cases (4.6%). CONCLUSION: Our results suggest that treatment of wide-necked aneuryms with stent placement after BAC yields low recanalization rates and enhanced angiographic outcomes in long-term follow-up.
PURPOSE: In the treatment of wide-necked aneurysms, stenting may be required after balloon-assisted coiling (BAC) for reconstructing the lumen/flow of the parent artery in cases of coil herniation. The potential benefits and complications of both techniques remain unclear when used together. Our aim was to assess the safety and long-term angiographic outcomes of stenting after BAC. METHODS: Retrospective review of 87 unruptured wide necked aneurysms (in 80 patients) treated with BAC and requiring stent placement at the final stage of the procedure due to coil prolapse. Aneurysm characteristics, technical issues, clinical records, and MR results were assessed. Post-treatment and follow-up angiograms were evaluated by two independent reviewers and categorized as "stable," "further thrombosis," or "recanalization." RESULTS: The mean maximum diameter was 9.1 ± 4.7 mm and aspect ratio 1.20 ± 0.47. Complete and near-complete initial occlusion were observed in 53 (60.9%) and 28 (32.2%) of all treated aneurysms, respectively. Angiographic follow-up (80 aneurysms; mean, 34.68 ± 25.26 months) revealed stability and further thrombosis in 92.4% (74/80). Recanalization was observed in six cases (7.5%, 6/83), four of which were retreated. No significantly different outcomes were found in terms of aneurysm size (p = 0.641). Transient and reversible procedure-related complications occurred in eight (9.2%), minor permanent deficits in 2.3%, and major deficits, including death, in four cases (4.6%). CONCLUSION: Our results suggest that treatment of wide-necked aneuryms with stent placement after BAC yields low recanalization rates and enhanced angiographic outcomes in long-term follow-up.
Authors: Yuichi Murayama; Yih Lin Nien; Gary Duckwiler; Y Pierre Gobin; Reza Jahan; John Frazee; Neil Martin; Fernando Viñuela Journal: J Neurosurg Date: 2003-05 Impact factor: 5.115
Authors: René Chapot; Christian Paul Stracke; Marta Wallocha; Reza Rikhtegar; Elif Yamac; Pascal John Mosimann Journal: J Neurointerv Surg Date: 2021-03-15 Impact factor: 5.836