An Analysis of Inflation Times During Balloon-Assisted Aneurysm Coil Embolization and Ischemic Complications

Abstract

Background and Purpose-The introduction of balloon remodeling has revolutionized the approach to coiling of wide-neck aneurysms. We studied the effects of balloon inflation during coil embolization on ischemic complications. Methods-A retrospective review was undertaken of the most recent 147 patients undergoing balloon remodeling for unruptured intracranial aneurysm coil embolization at a single institution (81 balloon, 66 unassisted). All underwent postprocedural MRI. Results-Among patients in the "balloon" group, the mean total inflation time was 18 minutes (range, 1-43), a mean number of inflations of 4 (range, 1-9), a mean maximum single inflation time of 7 minutes (range, 1-19), a mean reperfusion time of 2.2 minutes between inflations, and an average procedure time of 2 hours and 10 minutes. Asymptomatic diffusion-weighted imaging abnormalities were detected on postprocedural MRI in 21.5% of patients and symptomatic lesions were identified in 3.8%. Both silent and symptomatic ischemic rates were similar in the internal control group. Patients with ischemic findings were older and more likely have diabetes; no differences were found with respect to total balloon inflation time, number of inflations, maximum inflation time, or reperfusion times. Conclusions-We found no significant relationship between balloon inflation practices and ischemic events. Older and diabetic patients were more likely to have ischemic events develop.

Balloon-assisted endovascular treatment of intracranial dural arteriovenous fistulas

“…The use of balloon may increase the incidence of ischemic affairs (15). But in our group, no balloon related complication…”

Use of Onyx for Transarterial Balloon-Assisted Embolization of Traumatic Carotid Cavernous Fistulas: A Report of 23 Cases

“…Because of high blood rates of fistulas, even in total arterial steal, the damaged side of the cerebral hemisphere is in a state of relative hypoperfusion. Pre-and postoperative MR imaging should have been performed to identify asymptomatic cerebral infarction related to nondetachable balloons and flaking of solidified Onyx around the ostium, even though there is no significant relationship between balloon inflation practices and ischemic events, as reported by Spiotta et al, 27 and no new ischemic events were observed in any of these 23 patients either. Besides, long-term follow-up and larger case series are needed for further evaluation of the safety and efficacy of Onyx for the transarterial balloon-assisted embolization for TOCFs.…”

Y-Configuration Stent Placement (Crossing and Kissing) for Endovascular Treatment of Wide-Neck Cerebral Aneurysms Located at 4 Different Bifurcation Sites

“…The advent of self-expanding neurovascular stents and continued advances in endovascular techniques, such as balloon remodeling, [15][16][17] single stent reconstruction, 4,18 and transcirculation techniques 8 have greatly improved the ability to treat intracranial aneurysms. However, achieving an uncomplicated and complete obliteration of complex bifurcation aneu- rysms remains technically challenging.…”