Division of Interventional Neuroradiology, Department of Neurological Surgery, New York Presbyterian Hospital, Weill Cornell Medical Center, New York, New York, USA.
J Neurointerv Surg. 2013 Nov;5 Suppl 3:iii56-61. doi: 10.1136/neurintsurg-2012-010351. Epub 2012 Jun 22.
The balloon-assisted coil embolization (BACE) technique represents an effective tool for the treatment of complex wide-necked intracranial aneurysms; however, its safety is a matter of debate. This study presents the authors' institutional experience regarding the safety of the BACE technique.
428 consecutive patients with 491 intracranial aneurysms (274 acutely ruptured and 217 unruptured) treated with conventional coil embolization (CCE) or with BACE were retrospectively reviewed. All procedure-related adverse events were reported, regardless of clinical outcome. Thromboembolic events, intraprocedural aneurysm ruptures, device-related complications, morbidity and mortality were compared between the CCE and BACE groups.
The total rate of procedural and periprocedural adverse events was 9.6% (47/491 embolizations). Thromboembolic events, intraprocedural aneurysmal rupture and device-related complications occurred in 2.4%, 3.9% and 3.3% of procedures, respectively. The risk of thromboembolic events and device-related problems was similar between the CCE and BACE groups. A trend towards a higher risk of intraprocedural aneurysm rupture was observed in the BACE group (not statistically significant). The total cumulative morbidity and mortality for both groups was 2.6% (11/428 patients) and there was no statistically significant difference in the morbidity, mortality and cumulative morbidity and mortality rates between the two groups.
In this series of patients with acutely ruptured and unruptured aneurysms, the BACE technique allowed treatment of aneurysms with unfavorable anatomic characteristics without increasing the incidence of procedural complications.
球囊辅助线圈栓塞（BACE）技术是治疗复杂宽颈颅内动脉瘤的有效工具；然而，其安全性仍存在争议。本研究介绍了作者所在机构在 BACE 技术安全性方面的经验。
回顾性分析了 428 例 491 个颅内动脉瘤（274 个急性破裂和 217 个未破裂）患者，分别采用传统线圈栓塞（CCE）或 BACE 治疗。所有与手术相关的不良事件均被报告，无论临床结果如何。比较 CCE 组和 BACE 组之间血栓栓塞事件、术中动脉瘤破裂、器械相关并发症、发病率和死亡率。
总的手术和围手术期不良事件发生率为 9.6%（47/491 个栓塞术）。血栓栓塞事件、术中动脉瘤破裂和器械相关并发症的发生率分别为 2.4%、3.9%和 3.3%。CCE 组和 BACE 组的血栓栓塞事件和器械相关问题的风险相似。BACE 组术中动脉瘤破裂的风险呈上升趋势，但无统计学意义。两组总的累积发病率和死亡率为 2.6%（11/428 例患者），两组的发病率、死亡率和累积发病率和死亡率无统计学差异。
在本系列急性破裂和未破裂动脉瘤患者中，BACE 技术允许治疗具有不利解剖特征的动脉瘤，而不会增加手术并发症的发生率。
