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Wide-neck aneurysms: which technique should we use?

  • Laurent PierotEmail author
Letter to the Editor

Dear Editor-in-Chief,

We have read with a great interest the impressive paper of Velasco-Gonzalez et al. suggesting that combination of balloon-assisted coiling (BAC) and stenting is an interesting technique to treat wide-neck aneurysms (WNA) [1]. The authors have to be congratulated for the high quality of their results with morbimortality at 4.6% (including mortality 1.1%) and complete aneurysm occlusion at long-term follow-up in 81.2%.

Interestingly, this paper is showing that BAC, widely used in this center (more than 10 procedures per month) is not always sufficient to treat WNA as the additional use of a stent was needed in 26%.

However, several points are a matter of debates in this paper:
  1. 1.

    The methodology is debatable. Indeed, the title and the conclusion of the paper are somewhere suggesting that the combination of balloon-assisted coiling and stenting are part of a global strategy of treatment decided before the beginning of the procedure. However, the Methods section...

Notes

Compliance with ethical standards

Funding

NA.

Conflict of interest

LP consults for Balt, Microvention, Penumbra, Phenox and Vesalio.

Ethical approval

NA.

Informed consent

NA.

References

  1. 1.
    Velasco Gonzalez A, Stracke P, Nordmeyer H et al (2018) Low rates of recanalization for wide-neck aneurysms treated with stenting after balloon-assisted coiling: combination of techniques delivers stable and improved results during follow-up. Neuroradiology 60:1223–1230CrossRefGoogle Scholar
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    Kallmes DF, Brinjikji W, Cekirge S et al (2017) Safety and efficacy of the pipeline embolization device for treatment of intracranial aneurysms: a pooled analysis of 3 large studies. J Neurosurg 127:775–780CrossRefGoogle Scholar
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    Fiorella D, Molyneux A, Coon A, Szikora I, Saatci I, Baltacioglu F, Sultan A, Arthur A (2017) Demographic, procedural, and 30-day safety results from the WEB intra-saccular therapy study (WEB-IT). J NeuroIntervent Surg 9:1191–1196CrossRefGoogle Scholar
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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Neuroradiology DepartmentHôpital Maison Blanche, CHU ReimsReimsFrance

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