Safety and Efficacy of Balloon Remolding Technique in Wide Neck Aneurysm in Patients with Subarachnoid Hemorrhage

Document Type : Original Article

Authors

1 Department of Neurosurgery, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt.

2 Department of Neurology, Faculty of Medicine, Al-Azhar university, Cairo, Egypt

Abstract

Background: Wide neck aneurysms are challenging in their treatment. There is a continuous improvement and introduction of new treatment approaches. However, no consensus was found for the optimal treatment.
Aim of the work: This study aimed to investigate the safety and efficacy of balloon remolding technique in the treatment of wide neck aneurysm in patients presented with subarachnoid hemorrhage.
Patients and methods: Thirty patients were included. All patients were submitted to standard assessment including history taking [current, past, and family history]. This was followed by clinical examination [general and detailed neurological examination]. The aneurysm was graded and the success rate and reported complications or recurrence were documented in the follow up period. The clinical outcome has been recorded using the modified Rankin Scale [mRS]. Occlusion of the aneurysm was assessed by Raymond–Roy occlusion classification [RROC].
Results: The mean age was 50.90 ± 10.84 years and 18 males [60%]. Hypertension was reported in 33.3% and diabetes milieus in 46.%. The Modified Rankin scale score showed that, there were 6 cases [20%] with scale 1, there were 14 cases with scale 2 [46.7%], there were 8 cases [26.7%] with scale 3 and there were 2 cases [6.7%] with scale 4. The mean timing of coiling was 6.3 ± 4.89 days. The Raymond-Roy occlusion classification showed that, complete obliteration was reported in 80%, Residual neck in 16.7% and Residual aneurysm in 3.3%. The most common balloon type was Hyperform type in 76.7% followed by Hyperglide in 13.3%. Complications were reported in 5 cases, rupture in 4 cases [13.3%] and ischemia in 3.3%. There was no significant difference between the different scores of mRS regarding the demographic data and associated risk factors.
Conclusion: Treatment with Balloon Remodeling has been associated with high success rate and low incidence of complications.

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