| Balloon-assist technique for endovascular coil embolization of geometrically difficult intracranial aneurysms. | |
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MedLine Citation:
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PMID: 10834645 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The balloon-assist or neck-remodeling technique is an adjunctive method devised for the endovascular coil embolization of aneurysms characterized by a wide neck or unfavorable geometric features. Since its initial description, there have been few data to corroborate its utility, efficacy, and safety in aneurysm embolization. METHODS: Twenty patients (19 female patients and 1 male patient) with 22 aneurysms (19 unruptured aneurysms and 3 ruptured aneurysms) underwent balloon-assisted coil embolization. The balloon-assist technique was performed in the same treatment session after conventional coil embolization had failed in 55% of cases (12 of 22 cases) and was the primary treatment in 45% of cases. The majority of aneurysms were located in the supraclinoid carotid artery (13 paraophthalmic and 3 superior hypophyseal aneurysms). The mean angiographic measurements included a fundus of 8.7 +/- 3.7 mm, a neck of 5.3 +/- 2.2 mm, and a comparatively unfavorable fundus/neck ratio of 1.33 +/- 0.23. RESULTS: Technical success was achieved in 77% of cases (17 of 22). The rate of aneurysm obliteration at the end of the procedures was 97 +/- 3.8%. Angiographic follow-up data (mean follow-up period, 10.3 mo) obtained for 89% of the treated aneurysms (15 of 17) confirmed stable mean occlusion of 97.8 +/- 3.8%. Technical complications included two cases of asymptomatic distal vessel thromboembolism, which resolved angiographically within 24 hours, and one case of intraprocedural rupture of an arteriovenous malformation-related feeder artery aneurysm, which resulted in no neurological deficits and required no further treatment (transient complication rate, 13.6%; 3 of 22 cases). There were no deaths and no procedure-related 30-day or permanent morbidity. CONCLUSION: The balloon-assist method of coil embolization is characterized by promising intermediate-term angiographic and clinical outcomes and acceptable morbidity and mortality rates. Although this adjunctive method requires the use of an additional microcatheter and consequently involves a higher level of technical complexity, it extends the range of aneurysms that can be successfully treated with electrolytically detachable coils via an endovascular approach. |
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Authors:
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A M Malek; V V Halbach; C C Phatouros; T E Lempert; P M Meyers; C F Dowd; R T Higashida |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Neurosurgery Volume: 46 ISSN: 0148-396X ISO Abbreviation: Neurosurgery Publication Date: 2000 Jun |
Date Detail:
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Created Date: 2000-06-28 Completed Date: 2000-06-28 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 7802914 Medline TA: Neurosurgery Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1397-406; discussion 1406-7 Citation Subset: IM |
Affiliation:
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Department of Radiology, University of California, San Francisco, USA. ammalek@bics.bwh.harvard.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Aneurysm, Ruptured / radiography, therapy Angioplasty, Balloon / instrumentation* Cerebral Angiography Embolization, Therapeutic / instrumentation* Equipment Design Female Follow-Up Studies Humans Intracranial Aneurysm / radiography, therapy* Male Middle Aged Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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