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Background Eclipse 2L is a new double lumen balloon microcatheter for neurovascular use, with several design features that separate it from previous generation devices. We aimed to report our initial experience of balloon-assisted coiling of intracranial aneurysms using the Eclipse 2L balloon. Materials and methods Retrospective single-center review of patients who underwent balloon-assisted coiling with the Eclipse 2L balloon, for ruptured or unruptured intracranial aneurysms between 1 June 2016 and 31 December 2018. Cases with adjunctive use of stents and recurrences of previously embolized aneurysms were excluded. Patient files were used to extract aneurysm characteristics, complications, immediate and long-term results. Results We identified 120 patients with 126 aneurysms, of which 83 (65.8%) unruptured. Average aneurysm size was 5.9 mm (standard deviation 3.2 mm), with a dome-to neck-ratio of 1.7 (SD 0.6). Most aneurysms (79.3%) were wide necked. Immediate angiographic exclusion (Raymond-Roy grade I–II) was obtained in 95.1% of cases (81.7% grade I and 13.4% grade II). Procedural morbidity was 3.2% with no procedural mortality. Follow-up imaging was available for 115 aneurysms (91.2%). After an average follow-up period of 8.9 months (SD 7.3 months), 96.5% of aneurysms presented class I–II occlusion. Two aneurysms (1.7%) were retreated during follow-up. Conclusion Balloon-assisted coiling using the Eclipse 2L double lumen balloon is feasible for aneurysms in a wide range of locations in the anterior and posterior circulation. The angiographic results and complication rates compare favorably with previously published studies.

BackgroundTo date, the choice of optimal anesthetic management during endovascular therapy (EVT) of acute ischemic stroke patients remains subject to debate. We aimed to compare functional outcomes and complication rates of EVT according to the first-line anesthetic management in two comprehensive stroke centers: local anesthesia (LA) versus general anesthesia (GA).MethodsRetrospective analysis of prospectively collected databases, identifying all consecutive EVT for strokes in the anterior circulation performed between January 1, 2018 and December 31, 2018 in two EVT-capable stroke centers. One center performed EVT under LA in the first intention, while the other center systematically used GA. Using propensity score analysis, the two groups underwent 1:1 matching, then procedural metrics, complications, and clinical outcomes were compared. Good outcome was defined as 90 days modified Rankin Scale (mRS) ≤2, and successful recanalization as modified Thrombolysis In Cerebral Ischemia (mTICI) 2b-3.ResultsDuring the study period, 219 patients were treated in the LA center and 142 in the GA center. Using the propensity score, 97 patients from each center were matched 1:1 according to the baseline characteristics. Local anesthesia was associated with a significantly lower proportion of good outcome (36.1% vs 52.0%, OR 0.53, 95% CI 0.33 to 0.87; p=0.039), lower rate of successful recanalization (70.1% vs 95.8%, OR 0.13, 95% CI 0.04 to 0.39; pConclusionsIn this study, systematic use of GA for stroke EVT was associated with better clinical outcomes, higher recanalization rates, and fewer procedural complications compared with patients treated under LA as the primary anesthetic approach.

Introduction L’efficacite et la securite des thrombectomies mecaniques (TM) cerebrales realisees sous anesthesie locale sont peu etudiees. Nous avons compare les resultats des TM en utilisant deux strategies d’anesthesie en premiere intention : anesthesie locale (AL) dans un centre et anesthesie generale (AG) dans un deuxieme centre. Materiel et methodes Etude retrospective des TM de la circulation anterieure realises entre 01/01/2018 et 31/12/2018 dans deux centres francais de la meme region. Pendant cette periode, les TM dans le centre A ont ete effectues sous AL en premiere intention, et dans le centre B, toutes les TM ont ete effectues sous AG. Les deux populations de patients ont ete appariees 1 :1 en utilisant un score de propension calcule en fonction des caracteristiques cliniques et d’imagerie a l’admission. Les resultats angiographiques et cliniques apres TM ont ete compares entre les deux groupes apparies. Resultats Pendant la periode etudiee, 219 patients ont ete traites dans le centre A et 142 dans le centre B. Apres application du score de propension, 97 patients de chaque groupe ont ete apparies 1 :1 en obtenant deux groupes avec des caracteristiques initiales similaires. L’utilisation systematique de l’AG etait associee avec une proportion plus importante de patients independants a 3 mois (modified Rankin Score ≤ 2) (52,0 % vs 36,1 %, p = 0,039, OR : 0,53 IC95 % : 0,33–0,87), un taux plus eleve de recanalisation mTICI 2b-3 (95,8 % vs 70,1 %, p Conclusion Dans cette etude, l’utilisation systematique de l’anesthesie generale pour les TM a ete associee avec une meilleure reperfusion, moins de complications procedurales et une meilleure evolution clinique a 3 mois.