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PT  - JOURNAL ARTICLE
AU  - Kim Nelson, Peter
AU  - Levy, David I.
TI  - Balloon-assisted Coil Embolization of Wide-necked Aneurysms of the Internal Carotid Artery: Medium-term Angiographic and Clinical Follow-up in 22 Patients
DP  - 2001 Jan 01
TA  - American Journal of Neuroradiology
PG  - 19--26
VI  - 22
IP  - 1
4099  - http://www.ajnr.org/content/22/1/19.short
4100  - http://www.ajnr.org/content/22/1/19.full
SO  - Am. J. Neuroradiol.2001 Jan 01; 22
AB  - BACKGROUND AND PURPOSE: The management of broad-necked cerebral aneurysms by Guglielmi detachable coils (GDCs) is technically challenging owing to a variety of factors, including difficulty in defining the aneurysm/parent vessel interface angiographically and problems in achieving complete occlusion, later predisposing the aneurysm to regrowth/recanalization. We sought to determine whether the use of intraluminal balloons to remodel the parent vessel/aneurysm interface during GDC embolization would provide a safe means of improving the efficacy of endovascular treatment of broad-necked aneurysms.METHODS: Twenty-two saccular aneurysms of the internal carotid artery were treated with GDCs by using balloon remodeling techniques. All aneurysms were characterized by wide necks or were small with unfavorable neck/fundus ratios and required balloon assistance for coil embolization. Patients were followed up both clinically and angiographically.RESULTS: By using a microcatheter-mounted nondetachable balloon to provide a temporary barrier across the aneurysmal neck, we were able to deploy GDCs safely within a variety of aneurysms. Among the 22 patients treated, aneurysmal occlusion on follow-up angiography (mean, 19 months) was found in 17 of 20 patients (two patients died and no follow-up studies were available). Observed or suspected thromboembolic events occurred in four of 22 patients, resulting in one permanent deficit. Twenty of the 22 patients had good to excellent clinical outcomes.CONCLUSION: Although balloon-assisted coiling of cerebral aneurysms requires manipulation of a second microcatheter and an inflatable balloon, increasing its technical complexity, we believe that this method has utility in treating broad-necked aneurysms and small aneurysms that are otherwise suboptimally managed by conventional GDC deployment.