323 Comparison Between Balloon-Assisted and Stent-Assisted Technique for Treatment of Unruptured Internal Carotid Artery Aneurysms

Abstract

Abstract INTRODUCTION Balloon and stent are representative of assistant devices for wide-neck aneurysm coiling. To date, there were no studies comparing balloon-assisted (BAC) and stent-assisted coiling (SAC) for the treatment of internal carotid artery unruptured aneurysms (ICA-UA). METHODS We sought to characteristics of patients and aneurysms, and clinical and angiographic prognosis between groups. Total number of ICA-UA was 227 in 190 patients. Two groups were separted into BAC group (141 ICA-UA in 120 patients) and SAC group (86 ICA-UA in 70 patients). RESULTS >In SAC, aneurysm size and neck diameter tended to be larger than in BAC, but aneurysm volume and packed density of coil were not different between groups. Immediate angiographic occlusion grade was better for BAC than for SAC. Periprocedural thromboembolic events were more frequent during SAC (11.6%) than BAC (2.4%) per aneurysm, but hemorrhagic events were the opposite (2.4% for BAC and none for SAC per aneurysm) (P < 0.05). At discharge, treatment-related morbi-mortality rates were 1.6% for BAC and 1.4% per patient for SAC. At clinical follow-up (BAC, 118 patients [98.3%] for a mean of 48.4 months; SAC, 69 patients [98.6%], for a mean of 37.4 months), 1 additional treatment-related infarction occurred during SAC, resulting in a modified Rankin scale score of 4. Thus, overall treatment-related morbidity-mortality rates were 1.7% in BAC and 2.9% in SAC. At imaging follow-up (BAC, 135 aneurysms [95.7%] for 28.3 months; SAC, 81 aneurysms [94.1%] for 23.9 months), BAC and SAC showed stable or improved occlusion in 94.1% and 95.0%, minor recurrence in 4.4% and 2.5%, and major recurrence in 1.5% and 2.5%, respectively. CONCLUSION Both BAC and SAC were safe and effective techniques for ICA-UA. There were no differences in morbidity, mortality and recurrence rates between groups, despite their opposite trends.