Balloon combined with stent-assisted steel-coil embolization for the treatment of intracranial wide-necked aneurysms located at artery bifurcation sites / 介入放射学杂志

ABSTRACT

Objective To discuss the advantages of balloon combined with stent-assisted steel-coil embolization in treating intracranial wide-necked aneurysms located at artery bifurcation sites. Methods The clinical data of 20 patients with intracranial wide-necked aneurysms located at artery bifurcation sites (25 aneurysms in total), who were admitted to the First Affiliated Hospital of Kunming Medical University during the period from January 2014 to May 2014 to receive balloon combined with stent-assisted steel-coil embolization treatment, were retrospectively analyzed. Among the 20 patients, 16 had a history of subarachnoid hemorrhage and 4 had no history of subarachnoid hemorrhage. A total of 25 intracranial aneurysms located at artery bifurcation were detected; the locations included basilar terminal bifurcation (n=14), middle cerebral artery (MCA) bifurcation (n=8) and internal carotid artery (ICA) bifurcation (n=3). Three dimensional DSA was performed immediately and three months after the treatment , and the manifestations were evaluated according to Raymond classification. The clinical efficacy at three months after the treatment was assessed with the modified Rankin scale (mRS). Results Three dimensional DSA performed immediately after the balloon combined with stent-assisted steel-coil embolization treatment showed that among the 25 intracranial wide-necked aneurysms located at artery bifurcation 21 belonged to Raymond gradeⅠ, 2 belonged to Raymond grade Ⅱand 2 belonged to Raymond grade Ⅲ. Follow-up DSA performed three months after the treatment revealed that 20 aneurysms were Raymond grade Ⅰ, 3 aneurysms were Raymond gradeⅡand 2 aneurysms were Raymond grade Ⅲ. Three months after the treatment the mRS score was 0 point in 17 patients and one point in one patient, and the prognosis of these patients was good; the mRS score was 4-6 points in 2 patients, and the prognosis of the two patients was poor. Conclusion For the treatment of intracranial wide-necked aneurysms located at artery bifurcation sites, balloon combined with stent-assisted steel-coil embolization has obvious advantages.