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Thromboembolic events associated with balloon-assisted coil embolization: evaluation with diffusion-weighted MR
Sait Albayram1, Hakan Selcuk, Batuhan Kara
1Istanbul University, Cerrahpasa Medical School, Department of Radiology, Division of Neuroradiology, 34300 Kocamustafapasa, Istanbul, Turkey.
AJNR. American Journal of Neuroradiology
|December 1, 2004
Summary
Balloon-assisted coil placement for intracranial aneurysms has a 20% thromboembolic event rate. Key risk factors include microcatheter repositioning, coil removal, and larger aneurysm neck size.
Area of Science:
- Neurology
- Interventional Neuroradiology
- Vascular Surgery
Background:
- Thromboembolic events are a known complication of intracranial aneurysm treatment using Guglielmi detachable coils (GDCs).
- Balloon-assisted techniques are employed to improve coil placement and embolization efficacy.
Purpose of the Study:
- To determine the frequency of thromboembolic events during balloon-assisted coil placement for cerebral aneurysms.
- To identify risk factors associated with these thromboembolic events.
Main Methods:
- Retrospective analysis of 20 patients undergoing balloon-assisted coil embolization.
- Diffusion-weighted (DW) imaging performed within 6 hours post-procedure to detect ischemic lesions.
- Independent review of DW images by two neuroradiologists.
Main Results:
- Four patients (20%) exhibited new ischemic lesions on DW imaging.
- Lesions were predominantly in the posterior circulation territory.
- Increased risk associated with microcatheter/coil repositioning and larger aneurysm neck size (P < .01).
Conclusions:
- Balloon-assisted techniques do not appear to increase the risk of thromboembolic events compared to conventional GDC methods.
- Microcatheter repositioning, coil manipulation, and aneurysm neck size are significant risk factors.
- Balloon inflation parameters showed no strong correlation with lesion occurrence.