Combination of Multicatheter Plus Stent or Balloon for Treatment of Complex Aneurysms

Jeon, Hong Jun; Kim, B.M.; Kim, D.J.; Park, K.Y.; Kim, J.W.; Kim, D.I.

doi:10.3174/ajnr.a4526

Cited by 5 publications

(5 citation statements)

References 26 publications

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“…Procedural details were previously described in the literature [ 16 17 ]. Briefly, all patients with unruptured aneurysms who scheduled coil embolization received dual antiplatelet premedication (aspirin 100 mg and clopidogrel 75 mg) for at least 5 days.…”

Section: Methodsmentioning

confidence: 99%

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

Park

Kim

2016

Neurointervention

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PurposeTo compare clinical and angiographic outcomes between balloon-assisted (BAC) and stent-assisted coiling for internal carotid artery unruptured aneurysms (ICA-UA).Materials and MethodsA 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.ResultsAneurysm size and neck diameter were greater for SAC than in BAC, but aneurysm volume and coil packing density 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 morbi-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.ConclusionBoth BAC and SAC were safe and effective techniques for ICA-UA. There were no differences in morbi-mortality and recurrence rates between groups.

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Section: Methodsmentioning

confidence: 99%

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

Park

Kim

2016

Neurointervention

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“…Features commonly recognised in association with CIA are: giant aneurysms, localisation of difficult or morbid access, broad neck, branches arising from aneurysms, parental artery incorporation, blister-like or dissecting aneurysms, calcification of the aneurysmal wall, intraluminal thrombus, absence of collateral circulation, embedding on surrounding brain, brainstem, and cranial nerves, and previous treatments [ 8 - 12 , 16 , 17 ]. Including only patients undergoing endovascular treatment in this study determined that not all of the above-mentioned criteria could be applied.…”

Section: Discussionmentioning

confidence: 99%

Endovascular treatment of complex intracranial aneurysms

et al. 2018

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PurposeComplex intracranial aneurysms (CIA) are heterogenous group of intracranial vascular malformations. Due to its giant size, difficult location, broad neck, branches arising from the aneurysm, wall structure, calcification, presence of intraluminal thrombus or previous treatments it requires more careful approach. The aim of this study was to evaluate endovascular treatment results of CIA in our Department.Material and methodsIn order to differentiate CIA from all the aneurysms, treated endovascularly in years 2008-2014, authors proposed their own qualification criteria. Additionally, subgroup of patients with CIA with simultaneous subarachnoid haemorrhage (SAH) was divided. Clinical outcomes of patients were assessed with Glasgow Outcome Scale (GOS), while radiological outcomes were assessed with Montreal Scale. Aneurysm localization, incidence of aborted procedures, intraoperative complications were also evaluated.ResultsInternal carotid artery was the most common localization in both CIA and non-complex (nCIA) groups. Incidence of aborted procedures was significantly higher in CIA group than in nCIA (25% vs. 7%; p < 0.01). CIA group had worse Montreal scores then nCIA group (1.90 vs. 1.49; p < 0.01). Clinical outcome in GOS scale in patients with SAH and CIA was significantly worse than in SAH and nCIA (2.86 vs. 4.06; p = 0.04).ConclusionsTo conclude, proposed criteria of CIA should be taken into consideration during diagnosis and qualification to invasive treatment. Classifying aneurysm as CIA is related to greater possibility of aborting endovascular procedure due to technical difficulties.

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“… 2 Moreover, the uniqueness of the double axial catheter method inserted through an originally developed single catheter was demonstrated. This method has been reported for brain artery aneurysm repair, 3 however, this is the first case report to show the successful use of the technique in PHAA repair.…”

Section: Introductionmentioning

confidence: 91%

Coil Embolisation for Endovascular Treatment of Proper Hepatic Artery Aneurysm Using the Balloon Occlusion Technique

Akasaka

Saguchi

Kennoki

et al. 2018

EJVES Short Reports

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IntroductionEndovascular repair (ER) as a minimally invasive approach can be effective for treating hepatic artery aneurysm (HAA) with gratifying results. Microcoil embolisation is the main technique used in ER. However, the coil embolisation of a large proper HAA (PHAA) with a very wide neck tends to be extremely troublesome owing to the limited length of the inflow and outflow artery. Moreover, it is difficult because of rapid blood flow in the proper hepatic artery (PHA) and the difficulty in preserving its branch flow. Microcoil embolisation of the inflow and outflow of a PHAA with the balloon occlusion technique through an originally developed single guiding sheath system was performed successfully.ReportA 73 year old woman was diagnosed with large PHAA (65 mm) by computed tomography examination. The PHAA was successfully treated by endovascular embolisation with microcoils using the balloon occlusion technique through a single guiding sheath system.DiscussionThis method is safe and effective for the treatment of a large PHAA.

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Combination of Multicatheter Plus Stent or Balloon for Treatment of Complex Aneurysms

Abstract: BACKGROUND AND PURPOSE:Coiling of complex aneurysms is still difficult even with current adjuvant techniques. This study sought to evaluate the safety and effectiveness of a combination of multicatheter plus stent or balloon for the treatment of complex aneurysms.

Cited by 5 publications

References 26 publications

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

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

Endovascular treatment of complex intracranial aneurysms

Coil Embolisation for Endovascular Treatment of Proper Hepatic Artery Aneurysm Using the Balloon Occlusion Technique

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