The balloon-assisted coiling embolization in performing endovascular treatment of intracranial aneurysms: its clinical application and mid-to-long term effectiveness

Objective: To discuss the application of balloon-assisted coiling embolization (BACE) in performing endovascular treatment of intracranial aneurysms and to analyze its mid-to-long term effectiveness. Methods: A total of 48 patients with intracranial aneurysms, encountered in the hospital during the period from 2006 to 2011, were enrolled in this study. Most up-to-date BACE technique was employed in performing endovascular treatment of intracranial aneurysms in all the patients. Of the total 48 cases, acute subarachnoid hemorrhage was found in 38. Of the total 48 patients, wide-neck aneurysm was seen in 42, neck size > 4 mm in 7, dome-to-neck ratio ≤ 1.5 in 37. The maximum dimension of the aneurysm was 5-7 mm in 16 cases, 3-5 mm in 25 cases and < 3 mm in 7 cases. Cerebral angiography re-examination was carried out at 3, 12 and 24 months after the treatment. The results were analyzed. Results: BACE was successfully accomplished in 44 cases, and neuroform stent-assisted coiling embolization was adopted in the remaining 4 cases. Complete occlusion of the aneurysm was obtained in 39 cases, and subtotal occlusion of the aneurysm in 9 cases. Two patients developed ischemic events within 48 hours after the procedure. During the follow-up period, asymptomatic cerebral infarction was detected in 3 patients. At least one angiographic reexamination was carried out in 43 patients. Thirty-six patients were followed up for over 24 months. No re-canalized aneurysm was seen in the 39 patients whose aneurysms had been completely obstructed. Of the nine patients whose aneurysms had been sub-totally occluded, stable condition was seen in 2, progressive thrombosis in 2 and reopen of the aneurysms in 5, among them neuroform stent-assisted coiling embolization had to be employed in 3. No re-bleeding occurred in all cases. Conclusion: For the intracranial aneurysms with the maximum dimension < 7 mm, BACE is an effective and safe treatment, but sometimes neuroform stent-assisted coiling embolization may be needed for the wide-necked aneurysms. (authors)