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CC BY-NC-ND 4.0 · Asian J Neurosurg
DOI: 10.1055/s-0044-1779421
Case Report

Balloon-Assisted Stent Visualization: A Simple Technique for Precise Measurement of Previously Placed Stent Diameter

Manato Sakamoto 
1   Department of Neurosurgery, Saiseikai Shiga Hospital, Imperial Gift Foundation Inc., Ritto, Shiga, Japan
,
Shigeomi Yokoya
1   Department of Neurosurgery, Saiseikai Shiga Hospital, Imperial Gift Foundation Inc., Ritto, Shiga, Japan
,
Hidesato Takezawa
2   Department of Neurology, Saiseikai Shiga Hospital, Imperial Gift Foundation Inc., Ritto, Shiga, Japan
,
Midori Ichihashi
1   Department of Neurosurgery, Saiseikai Shiga Hospital, Imperial Gift Foundation Inc., Ritto, Shiga, Japan
,
Kengo Kishida
1   Department of Neurosurgery, Saiseikai Shiga Hospital, Imperial Gift Foundation Inc., Ritto, Shiga, Japan
,
Hideki Oka
1   Department of Neurosurgery, Saiseikai Shiga Hospital, Imperial Gift Foundation Inc., Ritto, Shiga, Japan
› Author Affiliations Funding None.
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Abstract

Stent-assisted coil embolization is effective for treating intracranial aneurysms, improving outcomes and reducing recurrence rates. However, accurately measuring the diameter of a previously placed stent during imaging can be challenging due to coil artifacts. This poses difficulties in determining the coil packing and size of additional stents needed during retreatment. In a reported case, the use of a balloon enabled precise assessment of stent deployment. A 50-year-old male with a history of basilar artery-left superior cerebellar artery aneurysm underwent coil embolization, direct clipping, and stent-assisted coil embolization (SAC) over a span of 14 years. However, the aneurysm showed reenlargement over time. To address the recurrence, a balloon was used to assess the previously placed Neuroform Atlas stent. Additional coils were inserted outside the stent, and a Low-profile Visualized Intraluminal Support Blue stent was added. Postoperatively, there were no new neurological issues, and a follow-up magnetic resonance imaging showed no ischemic lesions. Balloon-assisted stent visualization (BASV) may be a useful method in the retreatment of SAC. It has the potential to provide valuable information for treatment planning.

Keywords

balloon-assisted stent visualization (BASV) - stent-assisted coil embolization (SAC) - coil artifacts - Super-Compliant balloon

Ethical Approval Statement

This study was approved by the ethics committee of our hospital (Approval Number: 586).


Informed Consent

We obtained written informed consent from the patient for the publication of this case report and accompanying images.


Authors' Contributions

M.S, S.Y., and H.T. contributed to study conception and design. M.S. helped in data collection as well as analysis and interpretation of results. M.S., and S.Y., contributed to draft manuscript preparation. All authors (M.S., S.Y., H.T., M.I., K.K., H.O.) reviewed the results and approved the final version of manuscript.




Publication History

Article published online:
26 February 2024

© 2024. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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