Neuroform Stent Or Balloon Assisted Remodeling Technique And Coil Embolization Of Intracranial Wide-necked Aneurysms

objective: Neuroform stent or balloon assisted remodeling technique being able to avoid coil protrusion into the parent arteries, is the conventional method treating intracranial wide-necked aneurysm, but these two kinds method having it's characteristic respectively and applying to partial wide-necked aneurysms only,it's complication also has difference according to reports. Which method should be chosen to treat wide-necked aneurysms is undefined. In this paper is,through the study of treatment of 207 wide-necked aneurysms by Neuroform stent or balloon assisted remodeling technique and coil embolization ,to define the key facts to be noticed and the indication.Methods: Of the 207 patients with wide-necked aneurysms,129 were treated by Neuroform stent-assisted remodeling technique and coil embolization,78 were treated by balloon-assisted remodeling technique and coil emboliztion.The prognosis of the patients was evaluated with the modified Rankin scale 3 months after the procedure, and they were reexamined by cerebral angiography 6 to 12 months after the procedure.Results: The aneurysms of 114 patients were completely occluded with Neuroform stents in combination with coil embolization, 12 were subtotally occluded, and 3 were partially occluded. Among the aneurysms treated with ballon-assisted remodeling technique and coil embolization, 69 patients were completely occluded, and 9 were subtotally occluded. The good prognoses in the Neuroform stent-assisted group and balloon-assisted group were 77.2%(98/129) and 78.2%(61/78), respectively; the poor prognoses were 22.8%(29/129) and 20.5%(16/78), respctively; and the mortalities were 1.6%(2/129) and 1.3%(1/78), respectively. Forty-six patients were followed up with cerebral angiography after the procedures, of those, there were 32 patients in Neuroform stent-assisted group and 14 in the ballon-assisted group. Thirteen of 46 patients recanalized during the imaging follow-up, 7 improved on imaging, and 26 were stable.Conclusion: Neuroform stent or balloon-assisted remodeling in combination with coil and Neuroform stent alone are the effective methods in the treatment of intracranial wide-necked aneurysms. When parent artery is small and placement of stent is difficult, ballon-assisted remodeling should be chosed. When dome-neck ratio of aneurysm is less than 1, stent-assisted remodeling should be chosed.