✓ A balloon catheter technique for catheterization of human cerebral blood vessels is described. Temporary occlusion of different cerebral vessels was successfully accomplished in more than 300 cases, including investigations of collateral blood flow, intraarterial pressure, brain temperature, the vital staining of tumors, and the introduction of chemical agents. Temporary occlusion of the internal carotid artery makes possible angiography of the external carotid, while occlusion of separate branches of the external carotid permits selective angiography of its functioning branches. The balloon catheter is valuable in investigating arteriovenous and carotid-cavernous fistulas. With the help of a detachable balloon it is possible to occlude the cavity of arterial aneurysms or the afferent vessels of arteriovenous aneurysms; it is also useful as a means to shut off the blood flow to arterial aneurysms and carotid-cavernous fistulas when access is difficult. A method for reconstruction of the cavernous part of the carotid artery in cases of carotid-cavernous fistulas is described.
Nine patients with giant internal carotid artery (ICA) aneurysms (greater than 2.5 cm in diameter) were subjected to a combined extracranial-intracranial (EC-IC) bypass procedure and endovascular ICA occlusion during 1987 and 1988. The procedures were performed under one anesthetic. In all cases the collateral circulation had been judged insufficient on the basis of a strict preoperative testing protocol including: cerebral panangiography, electroencephalography, somatosensory potential recording, and cerebral blood flow monitoring during manual compression of the ICA in the neck. There were four intracavernous ICA aneurysms, four carotid-ophthalmic artery aneurysms, and one supraclinoid ICA aneurysm. All patients showed symptoms and signs of compression of the surrounding nervous structures. In the five cases of intradural lesions, the artery was occluded at the level of the aneurysm neck, so the ophthalmic artery had to be occluded. There was, nevertheless, no case of worsening of vision following surgery, and all nine patients showed significant improvement following the combined procedure. A combined EC-IC bypass procedure and endovascular ICA occlusion allows for immediate verification of the surgical results and appears to be a worthwhile method for treating giant intracranial aneurysms.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.