1237. The Peri-Procedural Complications of Stenting Versus Ballooning in Elective Endovascular Treatment in Unruptured Small Intracranial Aneurysms

Authors: Ahmed J. Awad, MD; Ha Nguyen; Leonardo Batista; Mahmoud Rayes; Justin Sweeney; Johnny Pryor; Raul Nogueira; Andrew Xavier; Rishi Gupta; Italo Linfante; Alexander Norbash; Osama Zaidat (Milwaukee, WI)

Introduction: The prevalence of intracranial aneurysms has been estimated as 2% in the adult population. Over the last decade, endovascular therapy (EVT) emerged as an effective treatment modality for aneurysms with outcomes comparable with the classic surgical clipping. The goal of this study is to compare the peri-procedural complications in stenting versus ballooning in treating unruptured small aneurysms Methods: A retrospective multi-center study of EVT of unruptured small aneurysms at 11 medical centers in the US. Inclusion criteria included elective EVT and small aneurysms < 11 mm in maximal diameter. Peri-procedural complication was defined as thromboembolic event (TEE), rupture within the first 24 hours post-procedure or death within the first 30 days of the procedure. Results: A total of 208 stents and 56 ballooning cases were identified. The incidence of TEE, rupture and death was 3.0%, 3.8% and 0.8%, respectively. The rupture risk (p = 0.02) and mortality (p = 0.009) in the ballooning group were significantly higher than the stenting group in aneurysms < 7mm. Conclusion: The endovascular therapy in unruptured small intracranial aneurysms is safe with low rates of complications and mortality. It appears that ballooning is associated with higher risks of rupture and mortality in aneurysms < 7mm compared to the stenting group.