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Comaneci plus Balloon-assisted Embolization of Ruptured Wide-necked Cerebral Aneurysms

Clinical Neuroradiology volume 32, pages 773–782 (2022)Cite this article

Abstract

Background and Purpose

Recently, avant-garde combinations of ancillary devices as an adjunct to coil embolization for acutely ruptured and wide-necked cerebral aneurysms have emerged. This study sought to investigate the feasibility, safety and durability of the simultaneous combination of temporary neck-bridging devices plus balloon-assisted coiling (BAC) to treat acutely ruptured and wide-necked cerebral aneurysms.

Methods

A retrospective review was performed of patients with ruptured and wide-necked intracranial bifurcation aneurysms treated with temporary stent plus balloon-assisted coiling. Anatomical features, technical details, intraprocedural complications, clinical and angiographic results were reviewed. Preprocedural and follow-up clinical statuses were evaluated using the modified Rankin scale (mRS).

Results

A total of 21 patients (mean age 54.5 years, range 37–72 years) were identified. The immediate postprocedural angiography revealed complete aneurysm occlusion in 85.7% (18/21) of the cases. A periprocedural complication developed in 9.5% of the cases. There was no mortality in this study. The permanent morbidity rate was 4.7%. Long-term follow-up angiography was performed in 18 of 21 patients (85.7%) (the mean follow-up period was 21 months). The rate of complete aneurysm occlusion at final follow-up was 89.4%.

Conclusion

The results of this study confirmed that temporary stent plus balloon-assisted coiling is a durable and relatively safe endovascular technique for the treatment of ruptured wide-necked bifurcation aneurysms located in both the posterior and anterior cerebral circulation.

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Funding

This study did not receive any funding or financial support.

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Authors and Affiliations

  1. Radiology Department, UH St Ivan Rilski, 1431, Sofia, Bulgaria

    A. Sirakov, S. Bogovski, S. Matanov, M. Penkov & S. Sirakov

  2. Interventional Neuroradiology Department, The Royal London Hospital, London, UK

    P. Bhogal

  3. Neurosurgery Department, UH St Ivan Rilski, Sofia, Bulgaria

    K. Minkin, H. Hristov, K. Ninov & V. Karakostov

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  1. A. Sirakov
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  2. P. Bhogal
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Correspondence to A. Sirakov.

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Conflict of interest

A. Sirakov, P. Bhogal, S. Bogovski, M. Matanov, K. Minkin, H. Hristov, K. Ninov, V. Karakostov, M. Penkov and S. Sirakov declare that they have no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article.

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Sirakov, A., Bhogal, P., Bogovski, S. et al. Comaneci plus Balloon-assisted Embolization of Ruptured Wide-necked Cerebral Aneurysms. Clin Neuroradiol 32, 773–782 (2022). https://doi.org/10.1007/s00062-021-01115-0

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Keywords

  • Bifurcational aneurysm
  • Aneurysms
  • Assisted coiling
  • Temporary stent-assisted coiling
  • Endovascular treatment