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http://dx.doi.org/10.3340/jkns.2010.48.3.207

Endovascular Treatment of Wide-Necked Intracranial Aneurysms Using Balloon-Assisted Technique with HyperForm Balloon  

Youn, Sang-O (Department of Neurosurgery, School of Medicine, Pusan National University)
Lee, Jae-Il (Department of Neurosurgery, School of Medicine, Pusan National University)
Ko, Jun-Kyung (Department of Neurosurgery, School of Medicine, Pusan National University)
Lee, Tae-Hong (Department of Neurosurgery, School of Medicine, Pusan National University)
Choi, Chang-Hwa (Department of Neurosurgery, School of Medicine, Pusan National University)
Publication Information
Journal of Korean Neurosurgical Society / v.48, no.3, 2010 , pp. 207-212 More about this Journal
Abstract
Objective : To assess the feasibility, safety, and effectiveness of the balloon-assisted technique with HyperForm balloon in the endovascular treatment of wide-necked intracranial aneurysms. Methods : A total of 34 patients with 34 wide-necked intracranial aneurysms were treated with endovascular coil embolization using balloon-assisted technique with Hyperform balloon. Twenty-nine aneurysms (85.3%) were located in the anterior circulation. The group of patients was comprised of 16 men and 18 women, aged 33 to 72 years (mean : 60.6 years). The size of aneurysms was in the range of 2.0 to 22.0 mm (mean 5.5 mm) and one of neck was 2.0 to 11.9 mm (mean 3.8 mm). The dome to neck ratio was ranged from 0.83 to 1.43 (1.15). Sixteen patients were treated for unruptured aneurysms and the remaining 18 presented with a subarachnoid hemorrhage. Results : In the 34 aneurysms treated by the remodeling technique with HyperForm balloon, immediate angiographic results consisted of total occlusion in 31 cases (91.2%) and partial occlusion in three cases (8.8%). There were five procedure-related complications (14.7%), including two coil protrusions and three thromboembolisms; Except one patient, all were successfully resolved without permanent neurologic deficit. No new bleeding occurred during the follow-up. Twenty patients (59%) underwent angiographic follow-up from 2 to 33 months (mean 9.2 months) after treatment. Focal recanalization with coil compaction of the neck portion was observed in 5 cases (25%). Only one case showed major recanalization and underwent stent-assisted coil embolization. Conclusion : The balloon-assisted technique with Hyperform balloon is a feasible, safe, and effective endovascular treatment of wide-necked cerebral aneurysms.
Keywords
Intracranial aneurysms; Wide-necked aneurysms; Endovascular treatment; Balloon-assisted technique;
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1 Biondi A, Janardhan V, Katz JM, Salvaggio K, Riina HA, Gobin YP : Neuroform stent-assisted coil embolization of wide-neck intracranial aneurysms: strategies in stent deployment and midterm follow-up. Neurosurgery 61 : 460-468; discussion 468-469, 2007   DOI   ScienceOn
2 Johnston SC, Dowd CF, Higashida RT, Lawton MT, Duckwiler GR, Gress DR; CARAT Investigators : Predictors of rehemorrhage after treatment of ruptured intracranial aneurysms : the Cerebral Aneurysm Rerupture After Treatment (CARAT) study. Stroke 39 : 120-125, 2008   DOI   ScienceOn
3 Lubicz B, Lefranc F, Bruneau M, Baleriaux D, De Witte O : Balloonassisted coiling of intracranial aneurysms is not associated with a higher complication rate. Neuroradiology 50 : 769-776, 2008   DOI   ScienceOn
4 Raymond J, Guilbert F, Roy D : Neck-bridge device for endovascular treatment of wide-neck bifurcation aneurysms : initial experience. Radiology 221 : 318-326, 2001   DOI   ScienceOn
5 Shapiro M, Babb J, Becske T, Nelson PK : Safety and efficacy of adjunctive balloon remodeling during endovascular treatment of intracranial aneurysms : a literature review. AJNR Am J Neuroradiol 29 : 1777-1781, 2008   DOI   ScienceOn
6 Suh SH, Kim BM, Park SI, Kim DI, Shin YS, Kim EJ, et al. : Stentassisted coil embolization followed by a stent-within-a-stent technique for ruptured dissecting aneurysms of the intracranial vertebrobasilar artery. Clinical article. J Neurosurg 111 : 48-52, 2009   DOI   ScienceOn
7 Tumialan LM, Zhang YJ, Cawley CM, Dion JE, Tong FC, Barrow DL : Intracranial hemorrhage associated with stent-assisted coil embolization of cerebral aneurysms : a cautionary report. J Neurosurg 108 : 1122-1129, 2008   DOI   ScienceOn
8 Malek AM, Higashida RT, Phatouros CC, Dowd CF, Halbach VV : Treatment of an intracranial aneurysm using a new three-dimensionalshape Guglielmi detachable coil : technical case report. Neurosurgery 44 : 1142-1144; discussion 1144-1145, 1999   DOI   ScienceOn
9 Ross IB, Dhillon GS : Balloon assistance as a routine adjunct to the endovascular treatment of cerebral aneurysms. Surg Neurol 66 : 593-601; discussion 601-602, 2006   DOI   ScienceOn
10 Raymond J, Guilbert F, Weill A, Georganos SA, Juravsky L, Lambert A, et al. : Long-term angiographic recurrences after selective endovascular treatment of aneurysms with detachable coils. Stroke 34 : 1398-1403, 2003   DOI   ScienceOn
11 Moret J, Cognard C, Weill A, Castaings L, Rey A : [Reconstruction technique in the treatment of wide-neck intracranial aneurysms. Longterm angiographic and clinical results. Apropos of 56 cases]. J Neuroradiol 24 : 30-44, 1997
12 Levy DI, Ku A : Balloon-assisted coil placement in wide-necked aneurysms. Technical note. J Neurosurg 86 : 724-727, 1997   DOI   ScienceOn
13 Moret J, Cognard C, Weill A, Castaings L, Rey A : The "remodelling technique" in the treatment of wide neck intracranial aneurysms. Angiographis results and clinical follow-up in 56 cases. Intervention Neuroradiol 3 : 21-35, 1997
14 Phatouros CC, Halbach VV, Malek AM, Dowd CF, Higashida RT : Simultaneous subarachnoid hemorrhage and carotid cavernous fistula after rupture of a paraclinoid aneurysm during balloon assisted coil embolization. AJNR Am J Neuroradiol 20 : 1100-1102, 1999
15 Lylyk P, Ferrario A, Pasbon B, Miranda C, Doroszuk G : Buenos Aires experience with the Neuroform self-expanding stent for the treatment of intracranial aneurysms. J Neurosurg 102 : 235-241, 2005   DOI   ScienceOn
16 Malek AM, Halbach VV, Phatouros CC, Lempert TE, Meyers PM, Dowd CF, et al. : Balloon-assist technique for endovascular coil embolization of geometrically difficult intracranial aneurysms. Neurosurgery 46 : 1397-1406; discussion 1406-1407, 2000   DOI   ScienceOn
17 Fiorella D, Albuquerque FC, Woo H, Rasmussen PA, Masaryk TJ, McDougall CG : Neuroform in-stent stenosis : incidence, natural history, and treatment strategies. Neurosurgery 59 : 34-42; discussion 34-42, 2006   DOI   ScienceOn
18 Guglielmi G, Viñuela F, Sepetka I, Macellari V : Electrothrombosis of saccular aneurysms via endovascular approach. Part 1 : Electrochemical basis, technique, and experimental results. J Neurosurg 75 : 1-7, 1991   DOI
19 Lefkowitz MA, Gobin YP, Akiba Y, Duckwiler GR, Murayama Y, Guglielmi G, et al. : Ballonn-assisted Guglielmi detachable coiling of wide-necked aneurysma : Part II--clinical results. Neurosurgery 45 : 531-537; discussion 537-538, 1999   DOI
20 Cekirge HS, Yavuz K, Geyik S, Saatci I : HyperForm balloon remodeling in the endovascular treatment of anterior cerebral, middle cerebral, and anterior communicating artery aneurysms : clinical and angiographic follow-up results in 800 consecutive patients. J Neurosurg, 2010 May 14 [Epub ahead of print]
21 Cottier JP, Pasco A, Gallas S, Gabrillargues J, Cognard C, Drouineau J, et al. : Utility of balloon-assisted Guglielmi detachable coiling in the treatment of 49 cerebral aneurysms : a retrospective, multicenter study. AJNR Am J Neuroradiol 22 : 345-351, 2001
22 Fernandez Zubillaga A, Guglielmi G, Vinuela F, Duckwiler GR : Endovascular occlusion of intracranial aneurysms with electrically detachable coils : correlation of aneurysm neck size and treatment results. AJNR Am J Neuroradiol 15 : 815-820, 1994
23 Sedat J, Chau Y, Mondot L, Vargas J, Szapiro J, Lonjon M : Endovascular occlusion of intracranial wide-necked aneurysms with stenting (Neuroform) and coiling : mid-term and long-term results. Neuroradiology 51 : 401-409, 2009   DOI   ScienceOn
24 Akpek S, Arat A, Morsi H, Klucznick RP, Strother CM, Mawad ME : Self-expandable stent-assisted coiling of wide-necked intracranial aneurysms : a single-center experience. AJNR Am J Neuroradiol 26 : 1223-1231, 2005
25 Benitez RP, Silva MT, Klem J, Veznedaroglu E, Rosenwasser RH : Endovascular occlusion of wide-necked aneurysms with a new intracranial microstent (Neuroform) and detachable coils. Neurosurgery 54 : 1359-1367; discussion 1368, 2004   DOI   ScienceOn