title: Balloon remodeling may improve angiographic results of stent-assisted coiling of unruptured intracranial aneurysms.
abstract: BACKGROUND
  Endovascular treatment of wide-necked and complex aneurysms may require stent-assisted coiling, either as primary stenting or combined with the balloon remodeling technique (BRT).
  
  
  OBJECTIVE
  To compare the angiographic results and clinical outcomes of both strategies in the Safety and Efficacy of Neuroform for Treatment of intracranial Aneurysms (SENAT) registry.
  
  
  METHODS
  SENAT was a prospective, multicenter registry that allowed BRT in conjunction with stenting and coiling with bare platinum coils. Clinical and angiographic outcomes of 97 patients with unruptured aneurysms treated with stenting, 51 after BRT (BRT+) and 46 without balloon assistance (BRT-), were retrieved from the SENAT database. Technical, clinical, and angiographic outcomes were compared between the 2 groups.
  
  
  RESULTS
  Periprocedural morbimortality and midterm clinical outcomes were not different between groups. Residual aneurysms were observed in 7.8% of BRT+ and in 21.7% of BRT- (P = .08) at the end of the stenting procedure. Four retreatments were performed during the follow-up period (2 BRT+, 2 BRT-). Twelve- to 18-month anatomic results showed a significant difference between groups, with a residual aneurysm being observed in 6.1% of BRT+ as compared to 22.7% of BRT- patients (P = .03).
  
  
  CONCLUSIONS
  Primary BRT followed by stent-assisted coiling may be associated with fewer residual aneurysms at 12 to 18 months as compared to stent-assisted coiling alone.
authors.affiliation: *CHUM Montréal, Neuroradiology, Montréal, Québec, Canada; ‡Université de Bretagne Occidentale, Groupe d'étude de la Thrombose en Bretagne Occidentale (EA 3878, GETBO), Brest, France; §CHU Besançon, Department of Neuroradiology and Endovascular Therapy, Besançon, France; ¶Fondation Ophtalmologique Adolphe de Rothschild, Neuroradiology, Paris, France; ‖CHU Dupuytren, Neuroradiology, Limoges, France; #Imaging Department, Imperial College Healthcare NHS Trust, Charing Cross Hospital; **CHU Montpellier, Neuroradiology, Montpellier, France.
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Gentric
authors.forename: Alessandra
authors.initials: A
authors.lastname: Biondi
authors.forename: Michel
authors.initials: M
authors.lastname: Piotin
authors.forename: Charbel
authors.initials: C
authors.lastname: Mounayer
authors.forename: Kyriakos
authors.initials: K
authors.lastname: Lobotesis
authors.forename: Alain
authors.initials: A
authors.lastname: Bonafé
authors.forename: Vincent
authors.initials: V
authors.lastname: Costalat
mesh_terms: D000328:Adult; D000368:Aged; D017130:Angioplasty / Q000009:adverse effects / Q000379:methods; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000379:methods*; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic / Q000379:methods; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012042:Registries; D019233:Retreatment / Q000706:statistics & numerical data; D015607:Stents; D016896:Treatment Outcome; D055815:Young Adult