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Document Type

Commentary

Abstract

Endovascular treatment with coils is widely used in the management of intracranial aneurysms. However, this type of treatment can be technically challenging for anatomic reasons, particularly when the neck of the aneurysm is wide or when the dome-to-neck ratio is not favorable. Previous studies described the remodeling technique for extending the indications and feasibility of the endovascular treatment to wide-neck intracranial aneurysms. In remodeling technique, a non-detachable balloon is temporarily inflated in front of the neck of the aneurysm during each coil placement. At the end of the procedure, the remodeling balloon is removed and no device is left in place in the parent vessel unless stent placement is subsequently performed. The remodeling technique can be used in all aneurysm locations but is adopted less frequently in anterior communicating and anterior cerebral aneurysms. Studies have also shown adequate aneurysm occlusion is significantly more frequent in the remodeling group. Despite the fact that aneurysms treated by the remodeling technique are different from aneurysms treated with standard coiling, the safety of both techniques is similar with a higher anatomic efficacy of the remodeling technique. Accordingly, wide use of the remodeling technique can be proposed.

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