Mario Martínez-Galdámez1, Kirill Orlov2, Krzysztof Kadziolka3, Mani Puthuran4, Vladimir Kalousek5, Boris Pabón6, Jorge Escartín7, Claudio Rodríguez7, Arun Chandran4, Dmitry Kislitsin2, Vadim Berestov2, Pedro Vega8, Carlos Diaz6, Guilherme Dabus9. 1. Endovascular Neurosurgery/Interventional Neuroradiology, Hospital Universitario Fundación Jiménez Diaz, Grupo Quironsalud, Madrid, Spain. mariomgaldamez@hotmail.com. 2. Endovascular Neurosurgery, Neurosurgery Department, National Medical Research Center, Meshalkin Clinic, Novosibirsk, Russian Federation. 3. Endovascular Neurosurgery, Neurosurgery Department, The Children's Memorial Health Institute, Western Hospital, Grodzisk Mazowiecki, Poland. 4. Department of Neuroradiology, The Walton Centre NHS Foundation Trust, Liverpool, UK. 5. Interventional Neuroradiology, Department of Radiology, Clinical Hospital Center "Sestre Milosrdnice", Zagreb, Croatia. 6. Interventional Neuroradiology, Angioteam-Angiosur, Medellín, Colombia. 7. Endovascular Neurosurgery/Interventional Neuroradiology, Hospital Universitario Fundación Jiménez Diaz, Grupo Quironsalud, Madrid, Spain. 8. Interventional Neuroradiology, Radiology Department, Hospital Universitario Central de Asturias, Oviedo, Spain. 9. Endovascular Neurosurgery, Miami Cardiac and Vascular Institute and Baptist Neuroscience Center, Miami, FL, USA.
Abstract
PURPOSE: Since appearance of the balloon-remodeling technique and stent-assisted coiling, complex aneurysms have been treated successfully by endovascular means worldwide. Although these two techniques have been widely proven, the combination of both traditionally made the procedures more complicated technically. The aim of our study was to determine the technical success, safety, and efficacy of the low-profile stents delivered through double lumen balloons. METHODS: Clinical, procedural, and angiographic data were analyzed. RESULTS: Eighty-four patients (55 women; age range 20-81 years) harboring 86 aneurysms were included in this study. Aneurysm maximal diameter ranged from 2 to 26 mm, with mean 7.5 mm. There were 62 unruptured, 15 recanalized, and 9 acutely ruptured aneurysms. Aneurysm locations were ACoA (31), MCA (36), supraclinoid ICA (4), carotid bifurcation (2), basilar (7), PCA (3), PICA (2), and VA (1). Ninety-three devices were implanted (63 LVIS jr, 15 LEO Baby, 14 ACCLINO Flex and 1 Neuroform Atlas) through the double lumen balloons (Scepter C or XC and Eclipse 2 L). We found 2 minor clinical events (2.4%) and 1 major event (1.2%). Total intra-procedural technical complication rate was 11.6%. Follow-up was available for 71 patients with an average follow-up of 7 months. Complete and near complete occlusion was 90.1%. Residual aneurysms were seen in 9.9%. CONCLUSION: The "combined remodeling technique" with low-profile stents delivered through double-lumen balloons is technically feasible, safe, and effective for the treatment of intracranial aneurysms. This technique allows the operator to avoid extra maneuvers.
PURPOSE: Since appearance of the balloon-remodeling technique and stent-assisted coiling, complex aneurysms have been treated successfully by endovascular means worldwide. Although these two techniques have been widely proven, the combination of both traditionally made the procedures more complicated technically. The aim of our study was to determine the technical success, safety, and efficacy of the low-profile stents delivered through double lumen balloons. METHODS: Clinical, procedural, and angiographic data were analyzed. RESULTS: Eighty-four patients (55 women; age range 20-81 years) harboring 86 aneurysms were included in this study. Aneurysm maximal diameter ranged from 2 to 26 mm, with mean 7.5 mm. There were 62 unruptured, 15 recanalized, and 9 acutely ruptured aneurysms. Aneurysm locations were ACoA (31), MCA (36), supraclinoid ICA (4), carotid bifurcation (2), basilar (7), PCA (3), PICA (2), and VA (1). Ninety-three devices were implanted (63 LVIS jr, 15 LEO Baby, 14 ACCLINO Flex and 1 Neuroform Atlas) through the double lumen balloons (Scepter C or XC and Eclipse 2 L). We found 2 minor clinical events (2.4%) and 1 major event (1.2%). Total intra-procedural technical complication rate was 11.6%. Follow-up was available for 71 patients with an average follow-up of 7 months. Complete and near complete occlusion was 90.1%. Residual aneurysms were seen in 9.9%. CONCLUSION: The "combined remodeling technique" with low-profile stents delivered through double-lumen balloons is technically feasible, safe, and effective for the treatment of intracranial aneurysms. This technique allows the operator to avoid extra maneuvers.