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Balloon-assisted coiling

Edgar Gerardo Ordónez-Rubiano, Christian Von-Diemling, William Cortes-Lozano, Nelson Oswaldo Lobelo-Garcia
Giant aneurysms have been treated with endovascular approaches like general, balloon-assisted and stent-assisted coiling, and flow diverter stent-assisted techniques. Few cases have been reported to be treated with both normal and large coils. Despite the mass effect, an adequate revascularization has been reported. An initial use of these coils is being reported in the current study. This is a case which has been successfully treated using a stent-assisted coiling with both small and large coils i.e., Penumbra Coil 400 (Penumbra, Inc...
August 31, 2016: Curēus
Bradley A Gross, Karam Moon, Andrew F Ducruet, Felipe C Albuquerque
BACKGROUND/OBJECTIVE: The rarity of petrous internal carotid artery (ICA) aneurysms has largely precluded analyses of their presentation and management in case series format. METHODS: We performed a retrospective analysis of our endovascular database of patients treated from January 2001 to May 2016 to identify patients with petrous ICA aneurysms. We evaluated the treatment approach and results for patients managed in the era of dedicated intracranial stents and flow diverters, noting clinical and angiographic results...
September 26, 2016: Journal of Neurointerventional Surgery
Kunpeng Chen, Lijun Wang, Daming Wang, Jiachun Liu, Jun Lu, Peng Qi
This study reports our experience of balloon-in-stent assisted coiling for the treatment of morphologically unfavorable aneurysms located in the internal carotid artery (ICA). From July 2007 to April 2014, twelve patients with twelve aneurysms located in the ICA were coil embolized by simultaneously using balloon and stent assistance. Five aneurysms were ruptured and seven were unruptured. All the aneurysms were overwide (dome-to-neck ratio ⩽1.2) and undertall (aspect ratio ⩽1.2) anatomically. The procedure-related adverse events, clinical and angiographic results were retrospectively analyzed...
September 19, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Kefu Cai, Yunfeng Zhang, Lihua Shen, Yaohui Ni, Qiuhong Ji
OBJECTIVE: The purpose of this study was to compare the efficacy, stability, and safety of stent-assisted coiling (SAC) and balloon-assisted coiling (BAC) in the treatment of ruptured wide-necked aneurysms in the acute period. METHODS: Consecutive patients including 65 cases treated with SAC and 32 with BAC were reviewed at authors' institution between November 2011 and December 2014. The efficacy of these two approaches and the incidence of periprocedural complications were retrospectively evaluated...
September 16, 2016: World Neurosurgery
Alejandro M Spiotta, Kyle M Fargen, Jonathan Lena, Imran Chaudry, Raymond D Turner, Aquilla S Turk, Daniel Huddle, David Loy, Richard Bellon, Donald Frei
INTRODUCTION: Traditional platinum coils used for cerebral aneurysm embolization have a uniform degree of softness throughout an individual coil's length. Recently, SMART Coils (Penumbra Inc., Alameda, CA) have been developed, which transition in softness along the length of their coils. We report the initial clinical results with this technology. METHODS: A retrospective study of all patients undergoing aneurysm coiling with SMART Coils at two centers was performed to evaluate the safety and efficacy of this new technology...
September 15, 2016: World Neurosurgery
Keun Young Park, Byung Moon Kim, Dong Joon Kim
PURPOSE: To compare clinical and angiographic outcomes between balloon-assisted (BAC) and stent-assisted coiling for internal carotid artery unruptured aneurysms (ICA-UA). MATERIALS AND METHODS: A total of 227 ICA-UA in 190 patients were treated with BAC (120 patients, 141 ICA-UA) or SAC (70 patients, 86 ICA-UA. We compared characteristics of patients and ICA-UA, and clinical and angiographic outcomes between groups. RESULTS: Aneurysm size and neck diameter were greater for SAC than in BAC, but aneurysm volume and coil packing density were not different between groups...
September 2016: Neurointervention
Mohamed Zidan, Matthias Gawlitza, Georgios Metaxas, Cédric Foussier, Sébastien Soize, Laurent Pierot
BACKGROUND AND PURPOSE: The safety of bare platinum coils has been widely described in the literature. This study aimed to report the first series of intracranial aneurysms treated with Barricade bare platinum coils with a comprehensive evaluation of their procedural safety and postprocedural anatomical results. METHODS: Patients with intracranial aneurysms treated between October 2013 and December 2015 by simple coiling or balloon-assisted coiling with Barricade coils (Blockade Medical, Irvine, California, USA) were prospectively included in a database and retrospectively studied...
October 2016: Journal of Neuroradiology. Journal de Neuroradiologie
Bradley A Gross, Felipe C Albuquerque, Karam Moon, Andrew F Ducruet, Cameron G McDougall
BACKGROUND/OBJECTIVE: The optimal management of residual or recurrent clipped aneurysms is infrequently addressed in the literature. METHODS: We reviewed our endovascular database from January 1998 to May 2016 to identify patients with clipped aneurysms undergoing subsequent endovascular treatment, evaluating treatment approach, and clinical and angiographic outcomes. RESULTS: 60 patients underwent endovascular treatment of residual/recurrent clipped aneurysms; 7 rebled prior to endovascular therapy...
August 8, 2016: Journal of Neurointerventional Surgery
Orlando Diaz, Leonardo Rangel-Castilla
Intracranial aneurysms are abnormal dilations of the intracranial vessels, in which all the layers of the vascular wall are affected by degenerative changes that lead to distension of the vessel. Intracranial aneurysms can be classified based on their anatomic location, size, and morphology. Subarachnoid hemorrhage is the most devastating clinical presentation. The goal of preventing hemorrhage or rehemorrhage can only be achieved by excluding the aneurysm from the cerebral circulation. Endovascular or surgical clipping can achieve this goal...
2016: Handbook of Clinical Neurology
José E Cohen, John M Gomori, Gustavo Rajz, Guy Rosenthal, Hosni Abu El Hassan, Samuel Moscovici, Eyal Itshayek
Extracranial vertebral pseudoaneurysms that develop following blunt trauma to the cervical area may have a benign course; however, embolic or ischemic stroke and progressive pseudoaneurysm enlargement may occur. We review the presentation and endovascular management of pseudoaneurysms of the cervical vertebral artery (VA) due to blunt trauma in nine patients (eight male, mean age 27years). Pseudoaneurysms occurred in dominant vessels in seven patients and coexisted with segmental narrowing in six. We favored endovascular intervention during the acute phase only in cases with significant narrowing of a dominant VA, especially when anticoagulation was contraindicated...
October 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Chuan-Chuan Wang, Wan-Ling Wen, Zheng-Zhe Feng, Yi Xu, Bo Hong, Jian-Min Liu, Qing-Hai Huang
OBJECTIVES: To evaluate the feasibility of endovascular treatment (EVT) for early branch aneurysms (EBAs) of the middle cerebral artery. METHODS: Two hundred eleven middle cerebral artery aneurysms (MCAAs) that received EVT between January 2012 and December 2014 were reviewed. The EBAs were identified according to their special patterns on cerebral angiography. The angiographic features, clinical outcomes, and angiographic results were investigated. RESULTS: Forty-eight EBAs (22...
July 5, 2016: World Neurosurgery
William R Stetler, Julius Griauzde, Yamaan Saadeh, Thomas J Wilson, Wajd N Al-Holou, Neeraj Chaudhary, B Gregory Thompson, Aditya S Pandey, Joseph J Gemmete
INTRODUCTION: Patients with an unruptured intracranial aneurysm treated with coil embolization are routinely admitted to the intensive care unit (ICU) after the procedure; however, this practice is questionable. The purpose of this study was to determine if routine admission to the ICU is necessary for patients undergoing coil embolization of an unruptured intracranial aneurysm. METHODS: We conducted a retrospective cohort study of all patients undergoing elective endovascular treatment of an unruptured intracranial aneurysm between 2005 and 2012 at our institution...
July 5, 2016: Journal of Neurointerventional Surgery
Peng Liu, Xianli Lv, Youxiang Li, Ming Lv
AIM: The aim of this study was to present the clinical and angiographic outcomes of A1 aneurysms treated by coil embolization. MATERIALS AND METHODS: We retrospectively evaluated 38 consecutive patients with A1 aneurysm (20 ruptured and 18 unruptured; mean age, 53.8 ± 11.9 years) from 2011 to 2014 treated by an endovascular approach in our hospital. Follow-up angiography was obtained in 30 patients. Clinical outcomes were evaluated by modified Rankin Scale (mRS) over telephone...
July 2016: Neurology India
Felipe Padovani Trivelato, Marco Túlio Salles Rezende, Luiz Venâncio Fonseca, Lucas Bonadio, Alexandre Cordeiro Ulhôa
PURPOSE: Balloon-assisted coiling (BAC) has made the treatment of aneurysms with complex shape and broad neck possible, especially during the acute phase of hemorrhage. The authors present a prospective series of their preliminary experience with the TransForm occlusion balloon catheter (TOBC). METHODS: Between September 2015 to February 2016 a total of 20 patients underwent endovascular treatment assisted by TOBC of which 19 had 20 untreated aneurysms and 1 patient harboring a meningioma was submitted to balloon test occlusion (BTO)...
June 20, 2016: Clinical Neuroradiology
Eimad Shotar, Bruno Law-Ye, Flore Baronnet-Chauvet, Sinead Zeidan, Dimitri Psimaras, Franck Bielle, Catherine Pecquet, Soledad Navarro, Charlotte Rosso, Fleur Cohen, Jacques Chiras, Federico Di Maria, Nader Sourour, Frédéric Clarençon
INTRODUCTION: Delayed onset of non-ischemic cerebral enhancing (NICE) lesions is a rare complication of intracranial aneurysms' endovascular therapy (EVT). The purpose of this study is to report this rare complication and its potential pathophysiology in a single-center case series and review the relevant literature. METHODS: After retrospective review of all patients managed by EVT at our institution from January 1, 2012 to December 31, 2014, 2 out of 374 patients (0...
September 2016: Neuroradiology
Fawaz Al-Mufti, Krishna Amuluru, Chirag D Gandhi, Charles J Prestigiacomo
Endovascular treatment of intracranial aneurysms with complex morphologies such as giant, wide-necked, or fusiform aneurysms is challenging. Stent-assisted coiling and balloon-assisted coiling are alternative techniques to treat such complex aneurysms, but studies have shown less-than-expected efficacy, as suggested by their high rate of recanalization. The management of complex aneurysms via microsurgery or conventional neuroendovascular strategies has traditionally been poor. However, over the last few years, flow-diverting stents (FDS) have revolutionized the treatment of such aneurysms...
July 2016: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
Jan Borggrefe, Daniel Behme, Anastasios Mpotsaris, Werner Weber
BACKGROUND: We investigated the complication rates of balloon-assisted coil embolization of ruptured and unruptured cerebral aneurysms dependent on their morphologic characteristics in angiography. METHODS: The study was a single-center retrospective analysis of all consecutive endovascular balloon-assisted coiling interventions performed between April 2008 and December 2013. Data were extracted from a prospective database on an intention-to-treat basis. We described the clinical (Hunt & Hess score, modified Rankin scale) and technical results (Raymond Roy aneurysm occlusion scale) and analyzed the rate of periprocedural complications with regard to aneurysm subgroups of bifurcation aneurysms versus sidewall aneurysms...
July 2016: World Neurosurgery
Fei Wang, Xun Chen, Yong Wang, Peng Bai, Huan-Zhi Wang, Tao Sun, Hua-Lin Yu
BACKGROUND: Stent-assisted coiling and balloon-assisted coiling are well-established minimally invasive techniques for treatment of intracranial aneurysms. The aim of this study was to use meta-analysis methods to compare clinical outcomes of aneurysms treated with stent-assisted coiling versus balloon-assisted coiling. METHODS: We searched for two-arm prospective studies and retrospective studies that compared the clinical outcomes in patients that received stent-assisted or balloon-assisted aneurysm treatment...
May 15, 2016: Journal of the Neurological Sciences
Laurent Pierot, Alessandra Biondi
Endovascular treatment is the first line treatment for intracranial aneurysms, but wide-neck aneurysms are often difficult to treat due to the difficulty in stabilizing the coils inside the aneurysm. It is singularly true for wide-neck bifurcation aneurysms (WNBA) as bifurcation branches often arise from the aneurysm neck. To overcome these difficulties, several approaches are available to treat both ruptured and unruptured aneurysms (balloon-assisted coiling and intra-aneurysmal flow disruption), while some techniques are essentially restricted to unruptured aneurysms due to the need of concomitant use of antiplatelet medications (stent-assisted coiling and flow diversion)...
June 2016: Journal of Neuroradiology. Journal de Neuroradiologie
Alejandro Santillan, Jeremiah Johnson, Lee A Birnbaum
A 13 year-old girl with a congenital carotid-jugular fistula presented with a pulsatile mass and a thrill on the left side of her neck. Angiography showed a fistula between the left internal maxillary artery and the jugular vein. The patient underwent coil embolization using a transarterial balloon-assisted technique and one week later, a transvenous approach. The fistula was completely obliterated, and the patient's symptoms resolved.
June 2016: Interventional Neuroradiology
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