• Adam N Wallace, Yasha Kayan, Josser E Delgado Almandoz, Jennifer L Fease, Anna A Milner, and Jill M Scholz.
• Division of Neurointerventional Radiology, Neuroscience Institute, Abbott Northwestern Hospital, Minneapolis, Minnesota; Department of Radiology, University of Iowa, Iowa City, Iowa, USA. Electronic address: adam.wallace@crlmed.com.
• World Neurosurg. 2019 Jan 1; 121: e798-e807.

BackgroundThe Scepter XC balloon catheter can be used for balloon-assisted coiling (BAC) of cerebral aneurysms but also accommodates delivery of a low-profile visible intraluminal stent (LVIS Jr.). We assessed the safety and effectiveness of BAC using the Scepter XC, with LVIS Jr. stent-assisted coiling (SAC) as a bailout option.MethodsA single-institution prospectively maintained neurointerventional database was reviewed for wide-necked (neck width ≥4 mm or dome/neck ratio <2) saccular aneurysms treated using the Scepter XC. Complication and angiographic occlusion rates of BAC and SAC procedures were compared. Multivariate logistic regression was used to identify variables predictive of complete aneurysm occlusion.ResultsThe cohort included 141 wide-necked saccular intracranial aneurysms treated in 135 procedures. SAC was used to treat 30% of aneurysms by deploying the LVIS Jr. through the Scepter XC. The overall procedural complication rate was 8.9%, including a 1.5% rate of symptomatic thromboembolic events and 3.0% rate of hemorrhagic complications, with no significant differences in complications between BAC and SAC procedures (P = 0.27). The overall complete or near-complete aneurysm occlusion rate was 96%, with trends toward higher complete aneurysm occlusion and lower retreatment rates with SAC (78 vs. 57%; P = 0.13; 0 vs. 8.4%, P = 0.13). Multivariate logistic regression identified aneurysm size, procedure technique (BAC or SAC), and duration of follow-up as independent predictors of complete aneurysm occlusion.ConclusionsUse of the Scepter XC for BAC, with LVIS Jr. SAC as a bailout option, shows acceptable angiographic and clinical results.Copyright © 2018 Elsevier Inc. All rights reserved.

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