Aneurysm recurrence following endovascular balloon occlusion

Endovascular balloon occlusion is an alternative treatment for surgically unclippable cerebral aneurysms. The results of aneurysm occlusion with either a silicone or a latex balloon in a common carotid artery bifurcation aneurysm model are compared to determine which type of balloon was least likely to result in aneurysm recurrence. Five rabbits each underwent endovascular balloon occlusion with either a silicone or a latex balloon, with seven rabbits serving as controls. At 3 months postocclusion, nine of the 10 balloon-treated aneurysms had recurred. The recurrent aneurysm tended to be larger in animals treated with silicone than with latex balloons. A dense fibrotic response was present around the collar of the latex balloons, but no significant fibrotic response was found in the silicone balloon group. This study suggests that with currently available balloons, the initial complete angiographic obliteration of an aneurysm following balloon occlusion should not be interpreted as a cure and that periodic follow-up angiography should be performed.