title: Thromboembolic events associated with balloon-assisted coil embolization: evaluation with diffusion-weighted MR imaging.
abstract: OBJECTIVE
  Thromboembolic events may occur during or after the treatment of intracranial aneurysms with Guglielmi detachable coils (GDCs). The purpose of this study was to determine the frequency of thromboembolic events associated with balloon-assisted coil placement and to investigate possible risk factors for these events during balloon-assisted coil placement and embolization.
  
  
  METHODS
  Twenty patients with cerebral aneurysms treated with balloon-assisted coil placement and embolization at our institution were included. All patients underwent diffusion-weighted (DW) imaging within 6 hours after the procedure. Two neuroradiologists reviewed all DW images to detect ischemic lesions.
  
  
  RESULTS
  Hyperintense lesions compatible with thromboembolic events were detected on DW images of four (20%) patients. Three lesions were in the territory of posterior circulation, and one was in the territory of anterior circulation. The occurrence of new lesions was strongly associated with the number of times the microcatheter or coil was repositioned and removed and with the size of the aneurysmal neck (P < .01). DW imaging findings did not suggest a strong correlation between the occurrence of new ischemic lesions and potential risk factors (maximum balloon inflation time, number of times the balloon was inflated, etc.) associated with balloon-assisted coil placement and embolization (P > .05).
  
  
  CONCLUSIONS
  The risk of thromboembolic events during the treatment of intracranial aneurysms with balloon-assisted techniques is not more significant than when conventional GDC techniques are used. The only variables found to influence this risk during or after balloon-assisted coil placement were microcatheter repositioning, coil removal and repositioning, and size of the aneurysmal neck.
authors.affiliation: Istanbul University, Cerrahpasa Medical School, Department of Radiology, Division of Neuroradiology, 34300 Kocamustafapasa, Istanbul, Turkey.
authors.forename: Sait
authors.initials: S
authors.lastname: Albayram
authors.forename: Hakan
authors.initials: H
authors.lastname: Selcuk
authors.forename: Batuhan
authors.initials: B
authors.lastname: Kara
authors.forename: Erhan
authors.initials: E
authors.lastname: Bozdag
authors.forename: Omer
authors.initials: O
authors.lastname: Uzma
authors.forename: Naci
authors.initials: N
authors.lastname: Kocer
authors.forename: Civan
authors.initials: C
authors.lastname: Islak
mesh_terms: D000328:Adult; D000368:Aged; D002545:Brain Ischemia / Q000175:diagnosis / Q000453:epidemiology; D002404:Catheterization / Q000009:adverse effects*; D002533:Cerebral Angiography; D038524:Diffusion Magnetic Resonance Imaging; D004621:Embolization, Therapeutic / Q000009:adverse effects* / Q000295:instrumentation; D005260:Female; D006801:Humans; D015994:Incidence; D002532:Intracranial Aneurysm / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D013923:Thromboembolism / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*