Balloon-assisted coil embolization and large stent delivery for cerebral aneurysms with a new generation of dual lumen balloons (Copernic 2L).

Guenego, Adrien; Zerlauth, Jean-Baptiste; Puccinelli, Francesco; Hajdu, Steven; Rotzinger, David C; Zibold, Felix; Piechowiak, Eike Immo; Mordasini, Pasquale; Gralla, Jan; Dobrocky, Tomas; Daniel, Roy T; Chapot, René; Mosimann, Pascal John (2018). Balloon-assisted coil embolization and large stent delivery for cerebral aneurysms with a new generation of dual lumen balloons (Copernic 2L). Journal of neurointerventional surgery, 10(4), pp. 395-400. BMJ Publishing Group 10.1136/neurintsurg-2017-013218

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INTRODUCTION Dual coaxial lumen balloon microcatheters through which small stents can be delivered have recently been described. We report a series of a new type of dual lumen balloon catheter with a parallel lumen design enabling enhanced inflation and deflation properties through which larger stents may be deployed, including flow diverters (FD). METHODS All aneurysms that were treated with a Copernic 2L (COP2L) dual lumen balloon catheter at our institution between February 2014 and December 2016 were assessed. Patient demographics, aneurysm characteristics, clinical and angiographic follow-up, as well as adverse events were analyzed. RESULTS A total of 18 aneurysms in 16 patients (14 women) were treated with the COP2L. Mean maximal aneurysm diameter was 6.4 mm, mean neck size was 3.3 mm (min 1; max 6.3), and mean aneurysm height/width was 1.1 (min 0.5; max 2.1). The COP2L was used for balloon-remodeled coiling exclusively in 2 aneurysms; coiling and FD stenting in 8; coiling and braided stent delivery in 3; coiling, braided and FD stenting in 1; and FD stenting without coiling in 4 (stenting alone). The rate of Roy-Raymond 1 (complete occlusion) changed from 22% in the immediate postoperative period to 100% at 3 months (mean imaging follow-up 8.2 months). There were three technical complications (3/16, 18.7%), including a perforation and two thromboembolic asymptomatic events that were rapidly controlled with the COP2L. There was no immediate or delayed morbidity or mortality (modified Rankin Scale score 0-1 in 100% of patients). CONCLUSION The COP2L is a new type of dual lumen balloon catheter that may be useful for balloon and/or stent-assisted coiling of cerebral aneurysms. The same device can be used to deliver stents up to 4.5 mm and to optimize stent/wall apposition or serve as a life-saving tool in case of thromboembolic or hemorrhagic events. Long-term efficacy and safety need to be further assessed with larger case-controlled cohorts.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology

UniBE Contributor:

Zibold, Felix; Piechowiak, Eike Immo; Mordasini, Pasquale; Gralla, Jan; Dobrocky, Tomas and Mosimann, Pascal John

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1759-8486

Publisher:

BMJ Publishing Group

Language:

English

Submitter:

Martin Zbinden

Date Deposited:

25 Oct 2017 09:08

Last Modified:

21 Mar 2018 01:30

Publisher DOI:

10.1136/neurintsurg-2017-013218

PubMed ID:

28754807

Uncontrolled Keywords:

aneurysms dual lumen balloon embolization large stent delivery onyx

BORIS DOI:

10.7892/boris.102472

URI:

https://boris.unibe.ch/id/eprint/102472

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