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Safety and efficacy of intracranial aneurysm embolization using the “combined remodeling technique”: low-profile stents delivered through double lumen balloons: a multicenter experience

  • Interventional Neuroradiology
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Abstract

Purpose

Since appearance of the balloon-remodeling technique and stent-assisted coiling, complex aneurysms have been treated successfully by endovascular means worldwide. Although these two techniques have been widely proven, the combination of both traditionally made the procedures more complicated technically. The aim of our study was to determine the technical success, safety, and efficacy of the low-profile stents delivered through double lumen balloons.

Methods

Clinical, procedural, and angiographic data were analyzed.

Results

Eighty-four patients (55 women; age range 20–81 years) harboring 86 aneurysms were included in this study. Aneurysm maximal diameter ranged from 2 to 26 mm, with mean 7.5 mm. There were 62 unruptured, 15 recanalized, and 9 acutely ruptured aneurysms. Aneurysm locations were ACoA (31), MCA (36), supraclinoid ICA (4), carotid bifurcation (2), basilar (7), PCA (3), PICA (2), and VA (1). Ninety-three devices were implanted (63 LVIS jr, 15 LEO Baby, 14 ACCLINO Flex and 1 Neuroform Atlas) through the double lumen balloons (Scepter C or XC and Eclipse 2 L). We found 2 minor clinical events (2.4%) and 1 major event (1.2%). Total intra-procedural technical complication rate was 11.6%. Follow-up was available for 71 patients with an average follow-up of 7 months. Complete and near complete occlusion was 90.1%. Residual aneurysms were seen in 9.9%.

Conclusion

The “combined remodeling technique” with low-profile stents delivered through double-lumen balloons is technically feasible, safe, and effective for the treatment of intracranial aneurysms. This technique allows the operator to avoid extra maneuvers.

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Abbreviations

CRT:

Combined remodeling technique

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Funding

No funding was received for this study.

Author information

Authors and Affiliations

  1. Endovascular Neurosurgery/Interventional Neuroradiology, Hospital Universitario Fundación Jiménez Diaz, Grupo Quironsalud, Madrid, Spain

    Mario Martínez-Galdámez, Jorge Escartín & Claudio Rodríguez

  2. Endovascular Neurosurgery, Neurosurgery Department, National Medical Research Center, Meshalkin Clinic, Novosibirsk, Russian Federation

    Kirill Orlov, Dmitry Kislitsin & Vadim Berestov

  3. Endovascular Neurosurgery, Neurosurgery Department, The Children’s Memorial Health Institute, Western Hospital, Grodzisk Mazowiecki, Poland

    Krzysztof Kadziolka

  4. Department of Neuroradiology, The Walton Centre NHS Foundation Trust, Liverpool, UK

    Mani Puthuran & Arun Chandran

  5. Interventional Neuroradiology, Department of Radiology, Clinical Hospital Center “Sestre Milosrdnice”, Zagreb, Croatia

    Vladimir Kalousek

  6. Interventional Neuroradiology, Angioteam-Angiosur, Medellín, Colombia

    Boris Pabón & Carlos Diaz

  7. Interventional Neuroradiology, Radiology Department, Hospital Universitario Central de Asturias, Oviedo, Spain

    Pedro Vega

  8. Endovascular Neurosurgery, Miami Cardiac and Vascular Institute and Baptist Neuroscience Center, Miami, FL, USA

    Guilherme Dabus

Authors
  1. Mario Martínez-Galdámez
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  2. Kirill Orlov
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  3. Krzysztof Kadziolka
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  4. Mani Puthuran
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  5. Vladimir Kalousek
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  6. Boris Pabón
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  7. Jorge Escartín
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  8. Claudio Rodríguez
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  9. Arun Chandran
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  10. Dmitry Kislitsin
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  11. Vadim Berestov
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  12. Pedro Vega
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  13. Carlos Diaz
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  14. Guilherme Dabus
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Corresponding author

Correspondence to Mario Martínez-Galdámez.

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Conflict of interest

GD consults for Microvention/Terumo.

Ethical approval

All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Martínez-Galdámez, M., Orlov, K., Kadziolka, K. et al. Safety and efficacy of intracranial aneurysm embolization using the “combined remodeling technique”: low-profile stents delivered through double lumen balloons: a multicenter experience. Neuroradiology 61, 1067–1072 (2019). https://doi.org/10.1007/s00234-019-02240-x

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  • DOI: https://doi.org/10.1007/s00234-019-02240-x

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