Balloon remodeling technique in endovascular treatment of intracranial aneurysms

Objetivos: O tratamento endovascular de aneurismas intracranianos demonstra baixas taxas morbidade e mortalidade, entretanto, aneurismas complexos e de colo largo permanecem um desafio terapeutico. O objetivo deste estudo e avaliar o manejo endovascular de uma serie de aneurismas intracranianos utilizando-se a tecnica de remodelagem com balao.Metodo: Realizou-se uma avaliacao retrospectiva de pacientes com aneurismas intracranianos submetidos a tratamento endovascular com a tecnica de remodelagem com balao no Instituto de Neurologia de Curitiba (Outubro de 2006 a Junho de 2011).Resultados: Foram analisados 34 pacientes. A media de idade era de 55,12 anos e 78,79% eram do sexo feminino. Treze pacientes apresentavam aneurismas rotos (38,24%) e em 8 havia vasoespasmo (23,53%). A maioria dos aneurismas (61,76%) tinham entre 5-15 mm de tamanho e 41,18% apresentavam colo maior ou igual a 4 mm. Uma oclusao total foi obtida em 29 aneurismas (85,29%) e parcial em 2 neurismas (5,88%). Ocorreu obito por hemorragia subaracnoidea relacionada ao procedimento em 1 caso.Conclusao: O tratamento endovascular com a tecnica de remodelagem com balao mostra-se segura e eficaz para o tratamento de aneurismas intracranianos, especialmente naqueles complexos e com colo largo. demonstrates low rates of morbidity and mortality. However,aneurysms with complex forms and wide neck remain atherapeutic challenge. The aim of this study is to evaluatethe endovascular management of a series of intracranialaneurysms using the balloon remodeling technique.Method: A retrospective evaluation was performed on patientswith intracranial aneurysms having undergone endovasculartreatment with balloon remodeling technique at the Institutode Neurologia de Curitiba (from October, 2006 to June, 2011).Results: Thirty-four patients were evaluated. The mean agewas 55.12 years and 78.79% were female. Thirteen patientshad ruptured aneurysms (38.24%) and 8 had vasospasm(23,53%). The majority of the aneurysms (61.76%) had domemeasurements between 5 to 15mm and 41.18% had a neck sizeof greater than or equal to 4mm. Total occlusion was obtainedin 29 aneurysms (85,29%) and partial occlusion in 2 (5.88%).One patient died from a procedure-related hemorrhage.Conclusion: Endovascular treatment with balloon remodelingtechniques seems to be a safe and effective treatment forintracranial aneurysms, especially those with complex formsand wide neck.