Balloon-assisted coiling of intracranial aneurysms is not associated with a higher complication rate.
BACKGROUND
Within the neurosurgical literature on intracranial aneurysms, balloon-assisted coiling (BAC) remains controversial when compared to conventional coiling (CC). The aim of this study was to compare our results with BAC and CC over a 4-year period.


METHODS
Daily interventional neuroradiology has been available since March 2004 in our institution. Between March 2004 and February 2008, 275 patients with 357 aneurysms were treated by an endovascular approach, including 174 patients/204 aneurysms treated by CC (group I) and 80 patients/92 aneurysms treated by BAC (group II). The remaining patients were treated with other endovascular techniques. Indications of BAC were as follow: aneurysms with an unfavourable neck/sac ratio and/or a branch arising from the neck (90.2%), unstable coiling catheter (6.5%), and anticipated aneurysm rupture (3.3%). The clinical charts, procedural data, and angiographic results of groups I and II were compared.


RESULTS
BAC was used in 25.8% (92/357) of all embolized aneurysms and it was successful in 83/92 aneurysms (90%). There was no significant difference in the procedure-related morbidity and mortality rates between group I (2.3% and 1.15%, respectively) and group II (2.5% and 1.25%, respectively). Although retreatment was more frequent in group II (13%) than in group I (11%), the difference was not statistically significant (P = 0.8125).


CONCLUSIONS
When BAC is used frequently, it is a safe and effective technique that is associated with complication rates comparable to those of CC. Although BAC is not associated with more stable anatomical results, it should be considered as an alternative therapeutic option for the treatment of broad-based intracranial aneurysms.
Lubicz
Boris
B
Department of Neuroradiology, Erasme University Hospital, Brussels, Belgium. blubicz@ulb.ac.be
Lefranc
Florence
F
Bruneau
Michaël
M
Balériaux
Danielle
D
De Witte
Olivier
O
D000328:Adult; D000368:Aged; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000628:therapy*; D021721:Balloon Occlusion; D004621:Embolization, Therapeutic / Q000009:adverse effects* / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011446:Prospective Studies; D011859:Radiography; D016896:Treatment Outcome; D055815:Young Adult