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Assisting techniques in the endovascular treatment of cerebral aneurysms
Author(s): ,
V. Kiselev
Affiliations:
Novosibirsk Federal Neurosurgical Center, Novosibirsk, Russian Federation
,
R. Gafurov
Affiliations:
Novosibirsk Federal Neurosurgical Center, Novosibirsk, Russian Federation
,
A. Sosnov
Affiliations:
Novosibirsk Federal Neurosurgical Center, Novosibirsk, Russian Federation
A. Perfilev
Affiliations:
Novosibirsk Federal Neurosurgical Center, Novosibirsk, Russian Federation
EANS Academy. Kiselev V. Oct 21, 2018; 226088; EP1061
Vitaly Kiselev
Vitaly Kiselev
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Abstract
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Purpose: to compare results of endovascular treatment of cerebral aneurysms with different assisting techniques.
Materials and methods: from 05.2014 to 05.2017 160 patients were operated using assistive techniques. Male - 43 (26.9%), female - 117 (73.1%). Age was from 18 to 74 years. Anterior circulation aneurysms were 108 (62.7%), posterior - 64 (37.1%). Size less than 15 mm was in 162 (94.1%) cases, more than 15 mm - 10 (5.9%). 46 (28.8%) patients had multiple aneurysms. The results of treatment were interpreted immediately and 6 months after the operationResults: 172 operations were performed. The balloon assistance used in 46 (26,7%) cases, stent-assisted coiling - 111 (64,5%), stent implantation after balloon-assisted coiling - 15 (8,8%) patients. Good results (mRs 0-1) were obtained in 144 (90%) patients. Total occlusion was reached in 152 (88.3%) aneurysms. The incidence of intraoperative complications was 2.3%, mortality 0%.
41 patients with 46 (26.7%) aneurysms were operated with balloon-assisted coiling. Total occlusion was achieved in 44 (95.6%) aneurysms. Favorable results (mRs 0-1) were obtained in 36 (87.8%) patients. Intraoperative complications were obtained in 2.1% of cases.
Using stent-assistance 104 patients with 111 (64.5%) aneurysms were operated. Total occlusion was obtained in 93 (83.7%) aneurysms. Favorable results (mRs 0-1) were obtained in 96 (92.3%) patients. Intraoperative complications were obtained in 0.9% of cases. The rate of recanalization after 6 months was 9.3%.A combination of balloon-assistance with subsequent stent implantation was performed in 15 patients with 15 (8.8%) aneurysms. Total occlusion was obtained in all patients of this group. Favorable results (mRs 0-1) were obtained in 12 (80%) patients. Intraoperative complications, including technical, were obtained in 13% of cases.
Conclusion: The use of the balloon-assist allows the most dense aneurysm coiling and, thus, achieves a higher rate of radicality than stent assistance (95.6% and 83.7%, respectively).
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