Comparison Between Balloon-Assisted and Stent-Assisted Technique for Treatment of Unruptured Internal Carotid Artery Aneurysms.
OBJECTIVE
To compare clinical and angiographic outcomes between balloon-assisted (BAC) and stent-assisted coiling for internal carotid artery unruptured aneurysms (ICA-UA).


METHODS
A total of 227 ICA-UA in 190 patients were treated with BAC (120 patients, 141 ICA-UA) or SAC (70 patients, 86 ICA-UA. We compared characteristics of patients and ICA-UA, and clinical and angiographic outcomes between groups.


RESULTS
Aneurysm size and neck diameter were greater for SAC than in BAC, but aneurysm volume and coil packing density were not different between groups. Immediate angiographic occlusion grade was better for BAC than for SAC. Periprocedural thromboembolic events were more frequent during SAC (11.6%) than BAC (2.4%) per aneurysm, but hemorrhagic events were the opposite (2.4% for BAC and none for SAC per aneurysm) (p < 0.05). At discharge, treatment-related morbi-mortality rates were 1.6% for BAC and 1.4% per patient for SAC. At clinical follow-up (BAC, 118 patients [98.3%] for a mean of 48.4 months; SAC, 69 patients [98.6%], for a mean of 37.4 months), 1 additional treatment-related infarction occurred during SAC, resulting in a modified Rankin scale score of 4. Thus, overall treatment-related morbi-mortality rates were 1.7% in BAC and 2.9% in SAC. At imaging follow-up (BAC, 135 aneurysms [95.7%] for 28.3 months; SAC, 81 aneurysms [94.1%] for 23.9 months), BAC and SAC showed stable or improved occlusion in 94.1% and 95.0%, minor recurrence in 4.4% and 2.5%, and major recurrence in 1.5% and 2.5%, respectively.


CONCLUSIONS
Both BAC and SAC were safe and effective techniques for ICA-UA. There were no differences in morbi-mortality and recurrence rates between groups.
Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea.; Severance Hospital Stroke Center, Yonsei University College of Medicine, Seoul, Korea.
Keun Young
KY
Park
Department of Radiology, Yonsei University College of Medicine, Seoul, Korea.; Severance Hospital Stroke Center, Yonsei University College of Medicine, Seoul, Korea.
Byung Moon
BM
Kim
Department of Radiology, Yonsei University College of Medicine, Seoul, Korea.; Severance Hospital Stroke Center, Yonsei University College of Medicine, Seoul, Korea.
Dong Joon
DJ
Kim
Aneurysm; Balloon; Coil embolization; Internal carotid artery; Stent