Balloon-assisted coil embolization of intracranial aneurysms is not associated with increased periprocedural complications.
BACKGROUND
The balloon-assisted coil embolization (BACE) technique represents an effective tool for the treatment of complex wide-necked intracranial aneurysms; however, its safety is a matter of debate. This study presents the authors' institutional experience regarding the safety of the BACE technique.


METHODS
428 consecutive patients with 491 intracranial aneurysms (274 acutely ruptured and 217 unruptured) treated with conventional coil embolization (CCE) or with BACE were retrospectively reviewed. All procedure-related adverse events were reported, regardless of clinical outcome. Thromboembolic events, intraprocedural aneurysm ruptures, device-related complications, morbidity and mortality were compared between the CCE and BACE groups.


RESULTS
The total rate of procedural and periprocedural adverse events was 9.6% (47/491 embolizations). Thromboembolic events, intraprocedural aneurysmal rupture and device-related complications occurred in 2.4%, 3.9% and 3.3% of procedures, respectively. The risk of thromboembolic events and device-related problems was similar between the CCE and BACE groups. A trend towards a higher risk of intraprocedural aneurysm rupture was observed in the BACE group (not statistically significant). The total cumulative morbidity and mortality for both groups was 2.6% (11/428 patients) and there was no statistically significant difference in the morbidity, mortality and cumulative morbidity and mortality rates between the two groups.


CONCLUSIONS
In this series of patients with acutely ruptured and unruptured aneurysms, the BACE technique allowed treatment of aneurysms with unfavorable anatomic characteristics without increasing the incidence of procedural complications.
Division of Interventional Neuroradiology, Department of Neurological Surgery, New York Presbyterian Hospital, Weill Cornell Medical Center, New York, New York, USA.
Alejandro
A
Santillan
Y Pierre
YP
Gobin
Jan C
JC
Mazura
Valerie
V
Meausoone
Lewis Z
LZ
Leng
Edward
E
Greenberg
Howard A
HA
Riina
Athos
A
Patsalides
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000601:surgery; D021721:Balloon Occlusion / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D002533:Cerebral Angiography; D002648:Child; D003627:Data Interpretation, Statistical; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D057510:Endovascular Procedures / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D007431:Intraoperative Complications / Q000453:epidemiology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000401:mortality; D012189:Retrospective Studies; D012306:Risk; D013923:Thromboembolism / Q000453:epidemiology / Q000209:etiology; D055815:Young Adult