High prevalence of t895 and t9364 spa types of methicillin-resistant Staphylococcus aureus in a tertiary-care hospital in Mexico: different lineages of clonal complex 5.

BACKGROUND: Staphylococcus aureus is a leading cause of broad-spectrum infections both in the community and within healthcare settings. Methicillin-resistant Staphylococcus aureus (MRSA) has become a global public health issue. The aim of this study was to examine the clinical and molecular characteristics of Staphylococcus aureus isolates and to define the population structure and distribution of major MRSA clones isolated in a tertiary-care hospital in Mexico. RESULTS: From April 2017 to April 2018, 191 Staphylococcus aureus isolates were collected. The frequency of MRSA was 26.7%; these strains exhibited resistance to clindamycin (84.3%), erythromycin (86.2%), levofloxacin (80.3%), and ciprofloxacin (86.3%). The majority of MRSA strains harbored the SCCmec type II (76.4%) and t895 (56.8%) and t9364 (11.7%) were the most common spa types in both hospital-associated MRSA and community-associated MRSA isolates. ST5-MRSA-II-t895 (New York /Japan clone) and ST1011-MRSA-II-t9364 (New York /Japan-Mexican Variant clone) were the most frequently identified clones. Furthermore, different lineages of Clonal Complexes 5 (85.4%) and 8 (8.3%) were predominantly identified in this study. CONCLUSION: Our study provides valuable information about the epidemiology of MRSA in a city of the central region of Mexico, and this is the first report on the association between t895 and t9364 spa types and ST5 and ST1011 lineages, respectively. These findings support the importance of permanent surveillance of MRSA aimed to detect the evolutionary changes of the endemic clones and the emergence of new strains.

NKG2C gene deletion in the Mexican population and lack of association to respiratory viral infections.

Expansion of a natural killer (NK) cell population that expresses NKG2C has been associated with cytomegalovirus and other viral infections. It has been suggested that this cell population may play a role in infection control. Deletion of the NKG2C gene (homozygous or heterozygous) has been reported with high prevalence in European and Asian populations. However, the effect of NKG2C genotype on NK cell responses to infection remains poorly defined. We determined the prevalence of the NKG2C deletion in a Mexican population (n = 300) and in a group of patients (n = 131) to assess whether NKG2C genotype affects the incidence of symptomatic viral infections caused by influenza or respiratory syncytial virus. The frequency of the NKG2C deletion haplotype in Mexican mestizos was significantly lower (10.3%) than that reported in other populations (17.5-21.9%). No difference in the prevalence of NKG2C deletion was observed in subjects with viral infections compared with the reference population. In addition, no differences in clinical characteristics and infection outcome were observed between patients with and without the NKG2C gene deletion. Our results indicate that copy number variation in the NKG2C gene has no impact on the severity of respiratory viral infections.

Influence of exposure to tobacco cigarette smoke on the eosinophil count in the nasal mucosa of young patients with perennial allergic rhinitis.

BACKGROUND: To assess the influence of exposure to tobacco cigarette smoke on the eosinophil count and the frequency of apoptosis of eosinophils in the nasal mucosa of teenagers with perennial allergic rhinitis. METHODS: Fifty patients were evaluated (aged 10 to 19 years old): 25 patients with and 25 patients with no recent exposure to tobacco cigarette smoke, by means of The Global Youth Tobacco Survey and cotinine/creatinine ratio. After a clinical evaluation, all the patients replied to a validated questionnaire of the severity of nasal symptoms; then, a nasal sample was processed to identify the eosinophil count and the frequency of apoptosis of eosinophils. RESULTS: Patients with active exposure to tobacco cigarette smoke had higher eosinophil counts than patients with no exposure to the smoke. In the two groups, apoptosis of eosinophils in the nasal mucosa was scarce and no significant correlation was observed between the frequency/severity of the nasal symptoms and the eosinophil count. CONCLUSION: Teenagers with perennial allergic rhinitis and active exposure to tobacco cigarette smoke may show increased eosinophil counts in the nasal mucosa, which might not be related to apoptosis of eosinophils or to the frequency/severity of nasal symptoms.

Electrosurgery for the Treatment of Moderate or Severe Rhinophyma. / Tratamiento con electrocirugía del rinofima moderado-grave.

Rhinophyma, a rare and progressive disfiguring condition, is thought to be the final stage of rosacea. Several surgical treatments are available, including dermabrasion, cryosurgery, scalpel excision, electrosurgery, and carbon dioxide laser. The last 2 techniques are the most effective for the management of rhinophyma. We describe a series of cases of moderate or severe rhinophyma treated with high-frequency electrosurgery in the dermatology department of Hospital Simón Bolivar and in private clinics in Bogota, Colombia, between 2012 and 2016. The cosmetic result, as assessed by both the clinicians and the patients, was satisfactory in all cases. Three patients presented hypertrophic scars that were treated with steroid injections and silicone gel sheeting. Two patients presented persistent erythema. However, there were no serious infections and none of the patients required further surgery. Electrosurgery is one of the simplest and most cost-effective techniques currently available for the treatment of rhinophyma by dermatologists.

Determination of the vertical profile of particle number concentration adjacent to a motorway using an unmanned aerial vehicle.

A quantitative assessment of the vertical profile of traffic pollution, specifically particle number concentration (PNC), in an open space adjacent to a motorway was possible for the first time, to the knowledge of the authors, using an Unmanned Aerial Vehicle (UAV) system. Until now, traffic pollution has only been measured at ground level while the vertical distribution, is limited to studies conducted from buildings or fixed towers and balloons. This new UAV system demonstrated that the PNC sampled during the period form 10 a.m. to 4 p.m., outside the rush hours with a constant traffic flow, increased from a concentration of 2 × 104 p/cm3 near the ground up to 10 m, and then sharply decreased attaining a steady value of 4 × 103 p/cm3 beyond a height of about 40 m. While more comprehensive investigations would be warranted under different conditions, such as topography and vehicle and fuel type, this finding is of great significance, given that it demonstrates the impact of traffic emissions on human exposure, but less so to pollution within the upper part of the boundary layer.

Complete Genome Sequence of Human Coronavirus OC43 Isolated from Mexico.

We report the complete genome sequence of the first Mexican human coronavirus (HCoV) OC43, obtained by new-generation sequencing and a metagenomic approach, isolated from a child hospitalized with pneumonia. The genome is closely related to the other OC43 genome sequences available, ranging from 99.8% to 98.2% nucleotide sequence identity.

[Most of the complaints in gynecology and obstetrics care are generated by perceptions stemming from unavoidable results]. / La mayoría de las quejas por atención ginecológica y obstétrica se generan por percepciones derivadas de resultados inevitables.

UNLABELLED: The annual rises in the cost of claims suffered by some countries had led to increases in: costs of the attention; malpractice premiums; health personnel stress level; risks for the patients with difficult problems, and lack of opportune attention. The intricate interaction between clinical state, responses variability and medical procedures flaws makes impossible stop unavoidable outcomes (UO). Though UO are not derived from negligence or inability, patients and relatives can see it as a malpractice result. OBJECTIVE: To determine the proportion of complaints generated by UO related perceptions (UORP) and their distribution in obstetric and gynecologic stages of care. MATERIAL AND METHODS: A search for claims derived from gynecologic or obstetric care was undertaken in the Medical Arbitrition National Commission (CONAMED) database, those presented between Jun. 1, 1996, and Nov. 30, 1998, were chosen. Some claims were derived directly from UORP (D-UORP claims), others were derived indirectly (UORP clamis); claims were grouped for stage of the attention in which they were originated; non D-UORP claims were grouped also by motives. RESULTS: In 625 claims (98.6% of total) was possible obtain precise information as required for the study. 79% of complaints were derived from UORP; 17% from perceptions generated for medical activities unrelated to UO (MAU-UO claims) and 4% by perception originated from care system (CS claims). 46% of complaints concerned surgical treatment, 27% medical treatment, 14% initial study, 2.1% delivery, in 10% a specific stage of the attention was not mentioned. The motives of the non D-UORP complaints were: 1) I-UORP claims; a) opportunity of the action, when the patient referred delay or inopportuneness as cause of the complaint (17%, overall); b) Professional quality, when questioned de outcomes or medical criteria (23%); 2) MAU-UO claims: a) Professional capacity when patient questions ability, or complaint of error in diagnosis (failure to diagnose or incorrect diagnosis), wrong removal, unnecessary treatment or other actions outside of the norm (13%); b) Improper information (3%); c) Inappropriate manner (0.8%); 3) CS claims: a) Resources (1%); b) Accessibility (2.9%). COMMENTS: The damage risk attributable to medical negligence is very low among patients who had received obstetrical or gynecological care, most of the complaints are UORP generated. In obstetrical care--from 1997 national statistics and described results--a benefit was procured to 1,705,161 persons and were produced 17 possible wrong attentions by professional capacity, five by improper information and one by inappropriate manner; the rest, 123 complaints, were derived from perceptions induced by UO. Undoubtedly there is low complaint registration, however, even at worst the wrong attention effect is lower than the impact attained if the possibility of economic benefit search through medical demands is not totally canceled. The damage risk derived from cost of claims is greater, as suffered on many countries. Medical associations in countries without professional liability problems must accomplish negotiations so that the legislation does not establish compensations by medical care results, the request may be based in: a) the deleterious consequences derived from cost of claims; and, b) the low probability of affecting the patients interests, in Mexico complaints derived from perceptions about the professional capacity are one in 103,022 obstetrical care attentions, the improper information derived one in 316,989 and the inappropriate manner generated one in 1,373,620. These organizations and other health related could assume the commitment to abate the foreseeable complaints and to do research on feasible forms to forecast UO, technically this must be long-range and though international collaboration.

[Lawsuits against gynecologists-obstetricians in the National Commission of Medical Arbitration]. / Demandas contra ginecoobstetras en la Comisión Nacional de Arbitraje Médico.

UNLABELLED: The study of claims motives is relevant since Obstetrics and Gynecology (O&G) is one of the specialties that it is involved with greater frequency in demands in the Medical Arbitration National Commission (CONAMED). OBJECTIVE: In order to know the causes by those which the patients have attended to be complained of the attention provided by a Obstetrician/Gynecologist (OG). MATERIAL AND METHODS: Between June 1, 1996, and November 30, 1998, there were 635 demands reported to the CONAMED for obstetrical or gynecological care, 375 (60%) derived from obstetrical care; claims were grouped by motives and for stage of the attention in which they were originated. RESULTS: There were more than 17 different causes of claim, the most frequent were: complications (20%), care not opportune (16%), accidents (15%), improper actions (15%), diagnostic error (10%). Claims were derived from: Surgical procedures (45%), medical treatment (27%) and diagnosis (13%). 15 (2.4%) of claims were generated from vaginal delivery, but only 9 (1.4%) were obstetrician related. Obstetric surgical procedures account for 23% of claims. CONCLUSIONS: OG are more claimed because work harder, more than one million vaginal and more than 500,000 cesarean deliveries are performed yearly in Mexico. The rates of reported claims are low, one per 10,000 deliveries attended; one per 275,000 vaginal deliveries, one per 8,400 obstetric surgical procedures. It all points OG claims as a probabilistic problem, risk related.

[Retroperitoneal leiomyoma. Report of a case]. / Leiomioma retroperitoneal. Informe de un caso.

Benign tumors of smooth muscle are relatively common in the genitourinary and gastrointestinal tracts. Retroperitoneal leiomyoma is a rare. A case of a 37 year old woman with diagnostic of leiomyoma of the uterus with the finding of retroperitoneal leiomyoma is presented.

[Maternity desire in patients undergoing assisted reproduction treatment at a public health institution]. / El deseo de maternidad en pacientes sujetas a tratamientos de reproducción asistida en una institución de salud pública.

The main purpose of this investigation was to define how different psychic representations of the desire for maternity have determined the decision of a group of patients to be under complicated reproductive treatments such as in vitro fertilization. A hundred patients who wanted to be under Assisted Human Reproduction (AHR) treatments in a public health institution were interviewed. Ten of them were selected to be studied in depth. The methodology employed was interpretative on a grounded theory design. Although this analysis included many factors, such as gender, family pressures, medical institution and side effects of this treatment, the two constant predominanting factors were narcisistic personality and the imaginary child.

[Treatment of pelvic endometriosis with goserelin acetate or nafarelin acetate. Comparative study]. / Tratamiento de la endometriosis pélvica con acetato de goserelina o acetato de nafarelina. Estudio comparativo.

The medical treatment of the pelvic endometriosis includes the hormonal therapy that attacks directly to the endometriosis lesions or indirectly it inhibits the endometrial proliferation and it induces atrophy through the estrogenic deprivation, or to inclination of a combination of these effects. The objective of the present study was to evaluate the effects of two gonadotrophin release analogs in the treatment of the endometriosis. 15 patients were studied in who the diagnosis settled down of endometriosis by means of laparoscope; these were formed two groups in aleatory form and there were administered to each one them nafarelin acetate in dose of 200 or 400 micrograms each 12 hours or goserelin acetate in dose of 3.6 mg every 21 days; the serum levels of the stimulating follicle, luteinizing, estradiol and prolactin hormones were determined at intervals of four weeks and the secondary effects of these drugs were reported. There were carried out a second look laparoscope in 10 patients. The statistical analysis was carried out by means of the test of hypothesis of Wilcoxon and X2. Inside those results were found that as much the nafarelin as the Goserelin are able to diminish the gonadotropins and estradiol serum levels. Both analogs are effective for the control of the endometriotic lesions. The secondary symptoms are smaller and better supported by the patients using nafarelin. In conclusion as much the nafarelin as the goserelin are appropriate medications for the treatment of the pelvic endometriosis and the election between one or another one can settle down for the comfort of application, secondary effects and cost.

[Scuba diving and pregnancy. A case report and review of the literature]. / Buceo y embarazo. Informe de un caso y revisión de la literatura.

The number of women in childbearing age participating in SCUBA dividing is increasing. Some dives during first trimester before pregnancy is confirmed. The preoccupation of both parents, is that the child could have any damage in the embryonal stage. This is a review of the literature and we present one case of a patient 28 years old with one immersion of 25 meters, at 28 days of gestation. The child did not present any congenital deformity at birth and his growth and development in the eighteen months have been normal.

[Comparative study of the management of abscesses of the abdominal wall after cesarean section]. / Estudio comparativo del manejo de abscesos de pared abdominal post-cesárea.

Abdominal wall wound dehiscences, more frequently those involving skin and subcutaneous tissue, are a common surgical complication in Obstetrics and Gynecology. A prospective, longitudinal study was done in 65 patients presenting with wound abscess. The evolution of the wound was compared using the following methods a) Bandage, b) Bandage with 30% iron subcarbonate pomade, c) Silk, d) Silk with 30% iron subcarbonate pomade. Eighty five percent of the patients, with silk used, were completely recovered in less than 10 days; comparing this option with the others used in this study, there were significant statistical differences.

[Transforming growth factor alpha (TGF-alpha) and epidermoid growth factor (EGF) in polycystic ovary syndrome: potential role in the decrease of apoptosis mechanisms in the follicle]. / El factor de crecimiento transformante-alpha (TGF-alpha) y el factor de crecimiento epidermoide (EGF) en el síndrome de ovarios poliquísticos: posible papel en la disminución de los mecanismos apoptóticos en el folículo.

Knowledgement on ovary function regulation is advancing. Classic concept about endocrine regulation by sexual hormones and gonadotrophin has turning to an hypothesis: autocrine and paracrine factors as intra-ovarian regulators. Follicular growth and steroidogenesis are mainly driven by follicle stimulating hormone (FSH), luteine hormone (LH) and steroids. On the other hand, the presence of intra-ovarian growth factors have an important role in modulation of gonadotrophin effects on ovarian functions. The influence of this factors on follicle growth are described.

A single pipeline embolization device is sufficient for treatment of intracranial aneurysms.

BACKGROUND AND PURPOSE: The Pipeline Embolization Device has emerged as an important treatment option for intracranial aneurysms. The number of devices needed to treat an aneurysm is uncertain and is the subject of vigorous debate. The purpose of this study was to compare rates of complications, aneurysm occlusion, and outcome in patients treated with a single-versus-multiple Pipeline Embolization Devices. MATERIAL AND METHODS: One hundred seventy-eight patients were treated with the Pipeline Embolization Device at our institution. Patients were divided into 2 groups: a single-device group (n = 126) and a multiple-device group (n = 52). RESULTS: There was no statistically significant difference between the 2 groups with respect to baseline characteristics except for age and aneurysm size (higher with multiple Pipeline Embolization Devices). Complications occurred more frequently with multiple (15%) versus a single device (5%, P = .03). In multivariate analysis, the use of multiple devices independently predicted complications. A similar proportion of patients achieved adequate aneurysm obliteration at follow-up in the single-device (84%) and the multiple-device groups (87%, P = .8). In multivariate analysis, age and follow-up time predicted obliteration. At follow-up, a significantly higher proportion of patients treated with a single device (97%) achieved a favorable outcome compared with those treated with multiple devices (89%, P = .03). In multivariate analysis, there was a strong trend for the use of a single device to predict favorable outcomes (P = .06). CONCLUSIONS: Treatment with a single Pipeline Embolization Device provides similar occlusion rates with less complications and better overall outcomes. These findings suggest that a single Pipeline Embolization Device is sufficient for treatment of most intracranial aneurysms.

Coiling of large and giant aneurysms: complications and long-term results of 334 cases.

BACKGROUND AND PURPOSE: Large and giant intracranial aneurysms are increasingly treated with endovascular techniques. The goal of this study was to retrospectively analyze the complications and long-term results of coiling in large and giant aneurysms (≥ 10 mm) and identify predictors of outcome. MATERIALS AND METHODS: A total of 334 large or giant aneurysms (≥ 10 mm) were coiled in our institution between 2004 and 2011. Medical charts and imaging studies were reviewed to determine baseline characteristics, procedural complications, and clinical/angiographic outcomes. Aneurysm size was 15 mm on average. Two hundred twenty-five aneurysms were treated with conventional coiling; 88, with stent-assisted coiling; 14, with parent vessel occlusion; and 7, with balloon-assisted coiling. RESULTS: Complications occurred in 10.5% of patients, with 1 death (0.3%). Aneurysm location and ruptured aneurysms predicted complications. Angiographic follow-up was available for 84% of patients at 25.4 months on average. Recanalization and retreatment rates were 39% and 33%, respectively. Larger aneurysm size, increasing follow-up time, conventional coiling, and aneurysm location predicted both recurrence and retreatment. The annual rebleeding rate was 1.9%. Larger aneurysm size, increasing follow-up time, and aneurysm location predicted new or recurrent hemorrhage. Favorable outcomes occurred in 92% of patients. Larger aneurysm size, poor Hunt and Hess grades, and new or recurrent hemorrhage predicted poor outcome. CONCLUSIONS: Coiling of large and giant aneurysms has a reasonable safety profile with good clinical outcomes, but aneurysm reopening remains very common. Stent-assisted coiling has lower recurrence, retreatment, and new or recurrent hemorrhage rates with no additional morbidity compared with conventional coiling. Aneurysm size was a major determinant of recanalization, retreatment, new or recurrent hemorrhage, and poor outcome.

Adverse events related to gastrointestinal endoscopic procedures in pediatric patients under anesthesia care and a predictive risk model (AEGEP Study).

BACKGROUND: Multiple studies have analyzed perioperative factors related to adverse events (AEs) in children who require gastrointestinal endoscopic procedures (GEP) in settings where deep sedation is the preferred anesthetic technique over general anesthesia (GA) but not for the opposite case. METHODS: We reviewed our anesthesia institutional database, seeking children less than 12 years who underwent GEP over a 5-year period. A logistic regression was used to determine significant associations between preoperative conditions, characteristics of the procedure, airway management, anesthetic approaches and the presence of serious and non-serious AEs. RESULTS: GA was preferred over deep sedation [77.8% vs. 22.2% in 2178 GEP under anesthesia care (n=1742)]. We found 96 AEs reported in 77 patients, including hypoxemia (1.82%), bronchospasm (1.14%) and laryngospasm (0.91%) as the most frequent. There were 2 cases of severe bradycardia related to laryngospasm/hypoxemia and a case of aspiration resulting in unplanned hospitalization, but there were no cases of intra- or postoperative deaths. Final predictive model for perioperative AEs included age <1 year, upper respiratory tract infections (URTI) <1 week prior to the procedure and low weight for the age (LWA) as independent risk factors and ventilation by facial mask as a protector against these events (p<0.05). CONCLUSIONS: AEs are infrequent and severe ones are remote in a setting where AG is preferred over deep sedation. Ventilatory AEs are the most frequent and depend on biometrical and comorbid conditions more than anesthetic drugs chosen. Age <1 year, history of URTI in the week prior to the procedure and LWA work as independent risk factors for AEs in these patients.

Endovascular treatment of posterior communicating artery aneurysms with oculomotor nerve palsy: clinical outcomes and predictors of nerve recovery.

BACKGROUND AND PURPOSE: ONP is a well-known presentation of PcomA aneurysms. Reports on recovery of ONP with endovascular coiling have been limited to small case series. We assessed the safety and efficacy of endovascular therapy in a series of PcomA aneurysms with ONP. MATERIALS AND METHODS: We reviewed 37 patients with ONP who underwent endovascular treatment in our institution between 2005 and 2011. Published studies were also reviewed to determine the overall rate of ONP recovery with endovascular therapy. RESULTS: Nineteen patients (51.4%) presented with complete ONP, and 18 (48.6%), with partial ONP. Conventional coiling was performed in 31 (83.8%) patients; stent-assisted coiling, in 4 (10.8%); and balloon remodeling, in 2 (5.4%). There was 1 (2.7%) procedural complication (a transient thromboembolic event). Twenty-seven (73%) patients were treated within 3 days from symptom onset. At the last available clinical follow-up, ONP resolution was complete in 14 (37.8%) patients and partial in 19 (51.4%). Only 4 (10.8%) patients showed no signs of nerve recovery. In multivariate analysis, partial ONP and longer follow-up durations were predictors of complete nerve recovery. Treatment timing, type of endovascular embolization, subarachnoid hemorrhage, and initial degree of aneurysm occlusion were not predictors of nerve recovery. Of 169 patients reported in the literature (including ours), ONP resolved completely in 73 (43.2%) patients and partially in 73 (43.2%). CONCLUSIONS: Endovascular therapy is a safe and highly efficient alternative to surgical clipping for PcomA aneurysms with ONP.

Spontaneous delayed migration/shortening of the pipeline embolization device: report of 5 cases.

Five patients were found to have spontaneous delayed migration/shortening of their Pipeline Embolization Devices on follow-up angiography. The device migrated proximally in 4 patients and distally in 1 patient. One patient had a subarachnoid hemorrhage and died as a result of migration of the Pipeline Embolization Device, and another patient presented with complete MCA occlusion and was left severely disabled. Mismatch in arterial diameter between inflow and outflow vessels was a constant finding. Migration of the Pipeline Embolization Device was managed conservatively, with additional placement of the device, or with parent vessel occlusion. Obtaining complete expansion of the embolization device by using a longer device, increasing vessel coverage, using adjunctive aneurysm coiling, and avoiding dragging and stretching of the device are important preventive measures. Neurointerventionalists should be aware of this potentially fatal complication and take all necessary preventive measures.

Stent-assisted coiling versus balloon remodeling of wide-neck aneurysms: comparison of angiographic outcomes.

BACKGROUND AND PURPOSE: Stent-assisted coiling and balloon-assisted coiling are 2 well-established techniques for treatment of wide-neck intracranial aneurysms. A direct comparative analysis of angiographic outcomes with the 2 techniques has not been available. We compare the angiographic outcomes of wide-neck aneurysms treated with stent-assisted coiling versus balloon-assisted coiling. MATERIALS AND METHODS: A retrospective review was conducted on 101 consecutive patients treated at our institution, 69 with stent-assisted coiling and 32 with balloon-assisted coiling. Two multivariate logistic regression analyses were performed to determine predictors of aneurysm obliteration and predictors of progressive aneurysm thrombosis at follow-up. RESULTS: The 2 groups were comparable with respect to all baseline characteristics with the exception of a higher proportion of ruptured aneurysms in the balloon-assisted coiling group (65.6%) than in the stent-assisted coiling group (11.5%, P < .001). Procedural complications did not differ between the stent-assisted coiling group (6%) and the balloon-assisted coiling group (9%, P = .5). The rates of complete aneurysm occlusion (Raymond score 1) at the most recent follow-up were significantly higher for the stent-assisted coiling group (75.4%) compared with the balloon-assisted coiling group (50%, P = .01). Progressive occlusion of incompletely coiled aneurysms was noted in 76.6% of aneurysms in the stent-assisted coiling group versus 42.8% in the balloon-assisted coiling group (P = .02). Retreatment rates were significantly lower with stent-assisted coiling (4.3%) versus balloon-assisted coiling (15.6%, P = .05). In multivariate analysis, stented aneurysms independently predicted both complete aneurysm obliteration and progression of occlusion. CONCLUSIONS: Stent-assisted coiling may yield lower rates of retreatment and higher rates of aneurysm obliteration and progression of occlusion at follow-up than balloon-assisted coiling with a similar morbidity rate.