====== Balloon-assisted coiling ======

[[Wide-neck aneurysm]]s represent a challenge for treatment in the setting of acute [[subarachnoid hemorrhage]]. [[Stent-assisted coiling]] (SAC) and [[balloon-assisted coiling]] (BAC) are well-known techniques for treating wide-necked aneurysms. [[Comaneci-assisted coiling]] (CAC) is a newer technique involving temporary stent deployment to assist an aneurysm [[coiling]].
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[[Stent-assisted coiling]] achieved better complete occlusion rates of aneurysms at 6 months or later after the procedure compared to [[balloon assisted coiling]], without being associated with a higher risk of intraprocedural complications and retreatment
((Wang F, Chen X, Wang Y, Bai P, Wang HZ, Sun T, Yu HL. Stent-assisted coiling
and balloon-assisted coiling in the management of intracranial aneurysms: A
systematic review & meta-analysis. J Neurol Sci. 2016 May 15;364:160-6. doi:
10.1016/j.jns.2016.03.041. Epub 2016 Mar 25. PubMed PMID: 27084238.)).
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[[Stent]] plus [[balloon]]-assisted [[coiling]] is a recently described [[endovascular]] technique that enables the [[coiling]] of wide-necked complex [[bifurcation aneurysm]]s by implanting only a single stent.

Aydin et al. investigated the feasibility, efficacy, safety, and durability of this technique for the treatment of [[wide-necked intracranial bifurcation aneurysm]]s.

A retrospective review was performed of patients with wide-necked intracranial bifurcation aneurysms treated with stent plus balloon-assisted coiling. The initial and follow-up clinical and angiographic outcomes were assessed. Preprocedural and follow-up clinical statuses were assessed using the modified Rankin scale.

Results: A total of 61 patients (mean age: 54.6 ± 10.4 yr) were included in the study. The immediate postprocedural digital subtraction angiography revealed complete aneurysm occlusion in 86.9% of the cases. A periprocedural complication developed in 11.5% of the cases. We observed a delayed ischemic complication in 4.9%. There was no mortality in this study. The permanent morbidity rate was 3.3%. The follow-up angiography was performed in 55 of 61 patients (90.1%) (the mean follow-up period was 25.5 ± 27.3 mo). The rate of complete aneurysm occlusion at the final angiographic follow-up was 89.1%. The retreatment rate was 1.8%.

Conclusion: The results of this study showed that stent plus balloon-assisted coiling is a feasible, effective, and relatively safe endovascular technique for the treatment of wide-necked bifurcation aneurysms located in the posterior and anterior circulation
((Aydin K, Stracke P, Berdikhojayev M, Barburoglu M, Mosimann PJ, Suleimankulov N, Sarshayev M, Sencer S, Chapot R. Safety, Efficacy, and Durability of Stent Plus Balloon-Assisted Coiling for the Treatment of Wide-Necked Intracranial Bifurcation Aneurysms. Neurosurgery. 2021 Apr 15;88(5):1028-1037. doi: 10.1093/neuros/nyaa590. Erratum in: Neurosurgery. 2021 May 13;88(6):1147. PMID: 33575798.)).