Wide-neck aneurysms: which technique should we use?
We have read with a great interest the impressive paper of Velasco-Gonzalez et al. suggesting that combination of balloon-assisted coiling (BAC) and stenting is an interesting technique to treat wide-neck aneurysms (WNA) . The authors have to be congratulated for the high quality of their results with morbimortality at 4.6% (including mortality 1.1%) and complete aneurysm occlusion at long-term follow-up in 81.2%.
Interestingly, this paper is showing that BAC, widely used in this center (more than 10 procedures per month) is not always sufficient to treat WNA as the additional use of a stent was needed in 26%.
The methodology is debatable. Indeed, the title and the conclusion of the paper are somewhere suggesting that the combination of balloon-assisted coiling and stenting are part of a global strategy of treatment decided before the beginning of the procedure. However, the Methods section...
Compliance with ethical standards
Conflict of interest
LP consults for Balt, Microvention, Penumbra, Phenox and Vesalio.
- 3.Pierot L, Spelle L, Berge J, Januel AC, Herbreteau D, Aggour M, Piotin M, Biondi A, Barreau X, Mounayer C, Papagiannaki C, Lejeune JP, Gauvrit JY, Costalat V (2018) Feasibility, complications, morbidity, and mortality results at 6 months for aneurysm treatment with the flow re-direction endoluminal device: report of SAFE study. J Neurointerv Surg 10:765–770CrossRefPubMedPubMedCentralGoogle Scholar
- 4.Pierot L, Spelle L, Berge J, Januel AC, Herbreteau D, Aggour M, Piotin M, Biondi A, Barreau X, Mounayer C, Papagiannaki C, Lejeune JP, Gauvrit JY, Derelle AL, Chabert E, Costalat V (2018) SAFE study safety and efficacy analysis of FRED embolic device in aneurysm treatment. J Neurointerv Surg:neurintsurg-2018-014261. https://doi.org/10.1136/neurointsurg-2018-014261
- 7.Pierot L, Moret J, Barreau X, Szikora I, Herbreteau D, Turjman F, Holtmannspötter M, Januel AC, Costalat V, Fiehler J, Klisch J, Gauvrit JY, Weber W, Desal H, Velasco S, Liebig T, Stockx L, Berkefeld J, Molyneux A, Byrne J, Spelle L (2018) Evaluation of the safety and efficacy of aneurysm treatment with WEB™ device in the cumulative population of 3 prospective, multicenter series (WEBCAST, French observatory, WEBCAST2). J NeuroIntervent Surg 10:553–559CrossRefGoogle Scholar