title: Assisted coiling of saccular wide-necked unruptured intracranial aneurysms: stent versus balloon.
abstract: OBJECTIVE
  Assisted coiling with stents or balloons enables a higher percentage of complete occlusions of saccular unruptured intracranial aneurysms to be achieved with a reasonable complication rate. The aim of this study was to compare stent-assisted coiling and the balloon remodeling technique in terms of efficacy, stability, and safety for the treatment of comparable unruptured saccular intracranial aneurysms.
  
  
  METHODS
  268 patients with 286 saccular unruptured wide-necked intracranial aneurysms were treated at our institution with stent- or balloon-assisted coiling and retrospectively reviewed. Statistical analysis was performed to assess significant differences between the two groups.
  
  
  RESULTS
  The rate of complete occlusion at the end of the procedure was higher with stent-assisted coiling than with balloon-assisted coiling (86.8% vs 78%) and the same results were also observed after 6 months (92.1% vs 77.6%; p=0.05). About 50% of major recurrences occurred in large to giant aneurysms (p<0.001). The overall complication rate was similar in the stent-assisted and balloon-assisted groups (10.3% vs 9.3%). Independently of the technique, a higher complication rate was observed with bifurcational aneurysms, particularly in the middle cerebral artery (p=0.016).
  
  
  CONCLUSIONS
  Stent-assisted coiling achieved better results in terms of complete occlusion and stability than balloon-assisted coiling with a lower rate of recurrence without being associated with a higher risk of intraprocedural complications. Bifurcational and large to giant aneurysms were associated with higher complication rates and higher recurrence rates, respectively, and still represent a challenge for both techniques.
authors.affiliation: Interventional Neuroradiology Unit, Careggi University Hospital, Florence, Italy.
authors.forename: Arturo
authors.initials: A
authors.lastname: Consoli
authors.affiliation: Department of Radiology, Careggi University Hospital, Florence, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Vignoli
authors.affiliation: Interventional Neuroradiology Unit, Careggi University Hospital, Florence, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Renieri
authors.affiliation: Interventional Neuroradiology Unit, Careggi University Hospital, Florence, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Rosi
authors.affiliation: Department of Radiology, Careggi University Hospital, Florence, Italy.
authors.forename: Ivano
authors.initials: I
authors.lastname: Chiarotti
authors.affiliation: Interventional Neuroradiology Unit, Careggi University Hospital, Florence, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Nappini
authors.affiliation: Interventional Neuroradiology Unit, Careggi University Hospital, Florence, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Limbucci
authors.affiliation: Interventional Neuroradiology Unit, Careggi University Hospital, Florence, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Mangiafico
mesh_terms: D000293:Adolescent; D000368:Aged; D021721:Balloon Occlusion / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D015607:Stents; D055815:Young Adult
keywords: Aneurysm; Balloon; Coil; Intervention; Stent