Coil Embolization of Wide-Neck Bifurcation Aneurysms Using a Single-Balloon Microcatheter.
BACKGROUND
Coil embolization of wide-neck cerebral aneurysms frequently requires stent or balloon assistance. Such approaches to coil embolization increase the procedural complexity, adding risk and cost.


OBJECTIVE
To describe a series of coil embolization procedures performed using a single-balloon microcatheter to treat wide-neck aneurysms and establish the safety, feasibility and efficacy of this technique.


METHODS
A retrospective review was performed to identify cases in which the Ascent balloon (Codman Neurovascular, Raynham, Mass., USA) was used as a single-balloon microcatheter for aneurysm coil embolization at two institutions. Clinical, demographic and angiographic data were obtained, and aneurysm volumes as well as packing densities (PD) were calculated.


RESULTS
Eight cerebral aneurysms were treated using this technique. Six of these were unruptured. The aneurysms had an average neck diameter of 3.7 mm, and the maximum dimension ranged from 5 to 11 mm, with a mean of 7.5 mm. The mean aspect ratio was 2.07. The mean volume of the aneurysms was 180.38 mm(3). The average PD achieved in these 8 aneurysms was 41.79%. Complete occlusion with coil embolization [Raymond-Roy Occlusion Classification (RROC) 1] was achieved in all cases except one, where a small residual was left deliberately and the occlusion grade was RROC 2. There were no intraprocedural complications.


CONCLUSIONS
This initial experience demonstrates the feasibility and immediate outcomes of a single-balloon microcatheter technique in coil embolization of wide-neck cerebral aneurysms. This technique may be used to achieve a high PD, comparable to that obtained with stent-assisted coiling or coiling alone, while avoiding permanent stent placement and potentially reducing thromboembolic complications.
University Specialty Clinics Neurology, University of South Carolina School of Medicine, Columbia, S.C., USA.
Sonal
S
Mehta
Department of Neurology, Michigan State University, East Lansing, Mich., USA.
Syed I
SI
Hussain
Department of Neurology and Psychiatry, Saint Louis University, St. Louis, Mo., USA.
Randall C
RC
Edgell
Aneurysm; Ascent balloon catheter; Balloon-assisted coil embolization; Packing density; Wide neck