Department of Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Department of Radiodiagnosis, All India Institute of Medical Sciences, Patna, Bihar, 801507, India.
Neurol India. 2022 Mar-Apr;70(2):643-651. doi: 10.4103/0028-3886.344626.
Wide-neck intracranial aneurysms need additional devices like balloons or stent for management. Balloon-assisted coiling has evolved both with interventionalist experience and device modifications.
We discussed our experience, evolution, and complications with this novel technique.
Data of 2014-2019 was retrospectively reviewed for type of balloon used along with complications in intracranial aneurysm coiling. Two hundred five aneurysms were detected in 188 patients, of which balloon-assisted coiling was planned for 198 aneurysms. Both single and double-lumen balloons were used. Aneurysms were divided into bifurcation and sidewall aneurysms. The complications were compared between bifurcation and sidewall aneurysms, and between single and double lumen balloons.
Balloon-assisted coiling was planned for 198 aneurysms but successfully done for 195 (98.5%) cases. Single-lumen balloons were used in 56 aneurysms (28.3%), and double-lumen balloons were used in 142 cases (71.7%). Procedural thromboembolism within parent vessel was seen in 28 cases (14.1%); however symptomatic were encountered in 5 cases (2.5%). Intraprocedural rupture of the aneurysmal sac was seen in 9 cases (4.5%). The procedure-related mortality in our series was 1.6% (3/188 patients), and morbidity was 4.3% (8/188 patients). The complications among bifurcation and sidewall aneurysms compared between single- and double-lumen balloons showed a greater number of symptomatic thromboembolic complications in sidewall aneurysms with the use of single lumen balloons.
There are significant symptomatic thromboembolic complications in sidewall aneurysms with the use of single-lumen balloons which decreased as interventionalist experience evolved and better hardware developed.
宽颈颅内动脉瘤需要额外的设备，如球囊或支架来进行治疗。随着介入医师经验的积累和器械的改进，球囊辅助弹簧圈技术也在不断发展。
我们讨论了这项新技术的经验、演变和并发症。
回顾性分析 2014 年至 2019 年的数据，分析使用的球囊类型以及颅内动脉瘤弹簧圈栓塞术的并发症。188 例患者共检出 205 个动脉瘤，其中 198 个计划行球囊辅助弹簧圈栓塞术。使用单腔和双腔球囊。动脉瘤分为分叉部和侧壁动脉瘤。比较分叉部和侧壁动脉瘤、单腔和双腔球囊之间的并发症。
计划行 198 个动脉瘤的球囊辅助弹簧圈栓塞术，但成功完成 195 个（98.5%）。56 个动脉瘤（28.3%）使用单腔球囊，142 个（71.7%）使用双腔球囊。28 例（14.1%）患者出现载瘤动脉内血栓栓塞；5 例（2.5%）患者出现症状性血栓栓塞。9 例（4.5%）患者发生瘤囊破裂。本研究中，手术相关死亡率为 1.6%（3/188 例），发病率为 4.3%（8/188 例）。分叉部和侧壁动脉瘤、单腔和双腔球囊之间的并发症比较显示，侧壁动脉瘤使用单腔球囊时，症状性血栓栓塞并发症较多。
随着介入医师经验的积累和更好的硬件设备的发展，侧壁动脉瘤使用单腔球囊时会出现严重的症状性血栓栓塞并发症。
