title: An analysis of inflation times during balloon-assisted aneurysm coil embolization and ischemic complications.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Neurological Surgery, Cerebrovascular Center, Cleveland Clinic, 9500 Euclid Avenue, S40, Cleveland, OH 44195, USA. spiotta@ccf.org
authors.forename: Alejandro M
authors.initials: AM
authors.lastname: Spiotta
authors.forename: Tarun
authors.initials: T
authors.lastname: Bhalla
authors.forename: Muhammad S
authors.initials: MS
authors.lastname: Hussain
authors.forename: Thinesh
authors.initials: T
authors.lastname: Sivapatham
authors.forename: Ayush
authors.initials: A
authors.lastname: Batra
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Hui
authors.forename: Peter A
authors.initials: PA
authors.lastname: Rasmussen
authors.forename: Shaye I
authors.initials: SI
authors.lastname: Moskowitz
mesh_terms: D000368:Aged; D021721:Balloon Occlusion / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D002545:Brain Ischemia / Q000453:epidemiology* / Q000517:prevention & control; D002536:Cerebral Arteries / Q000473:pathology; D015897:Comorbidity; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology* / Q000517:prevention & control; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors