Balloon-assisted coil embolization of intracranial aneurysms

Abstract

In an extensive clinical series, Sluzewski and colleagues evaluated the risks associated with balloon-assisted coil embolization (BACE) of intracranial aneurysms. Specifically, these experienced authors analyzed the results in 71 cases in which BACE was performed and compared the data with those from a group of 756 aneurysms in which coil embolization (CE) alone was used. Hence, during the interval between 1995 and 2005, the authors treated 827 intracranial aneurysms by using endovascular techniques. They observed that BACE was more frequently utilized in larger aneurysms with broad necks, unruptured lesions, and lesions in the posterior circulation. Predictably, balloon-assisted techniques had a higher procedural complication rate of 14.1% compared with the 3% rate in the conventional CE interventions. Follow-up evaluations of these 71 aneurysms were somewhat limited: only 52 lesions had 6-month angiography follow-up data. At that time, 71% of the lesions were completely occluded and 29% still had residual filling. Of the 15 incompletely obliterated aneurysms, 10 were subjected to additional intervention, including two surgical clip applications. Long-term follow up of these incompletely treated aneurysms was limited, but the authors report that at a meeting 28 months posttreatment none in this group demonstrated repeated hemorrhage.