Balloon catheterization and occlusion of major cerebral vessels

Abstract

✓ 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.

Estudo comparativo entre aneurismas rotos tratados por cirurgia e por via endovascular

“…A introdução desta técnica 3 , para o tratamento endovascular de aneurismas intracranianos propiciou uma grande evolução, principalmente após a introdução de GDC, na década de 90. O tratamento cirúrgico tem conduzido a grande melhora dos resultados clínicos após a utilização de técnicas microcirúrgicas para a clipagem dos aneurismas 1,2 .…”

“…Os resultados do tratamento cirúrgico dos aneurismas tem melhorado após a aplicação de técnicas microscópicas e do tratamento clínico e cirúrgico precoces após a sua ruptura 1,2 . As técnicas do tratamento endovascular têm evoluido muito nestes úl-timos anos, após os primeiros relatos de Serbinenko em 1974 3 . Isto conduziu a ampla utilização da téc-nica no tratamento dos aneurismas intracranianos, até mesmo em casos em que uma clipagem cirúrgi-ca seria possível, devido ao caráter menos invasivo da embolização por GDC.…”

Traumatic Middle Meningeal Artery and Fistula Formation with the Cavernous Sinus and a Review of the Literature on Endovascular Management of Traumatic Carotid Cavernous Fistulas

“…Ever since the use of balloons for the treatment of TCCFs was described by Debrun et al [13] and Serbinenko, [14] transarterial balloon embolization has been the criterion standard treatment for most patients with TCCF. Higashida et al [15] reported preservation of the parent artery in 88% of patients with TCCFs treated by using detachable balloons; other authors have described a need for parent artery occlusion in as many as 20% of cases [16,17].…”

Role of Embolization for Cerebral Arteriovenous Malformations

“…Serbinenko subsequently reported in 1974 his development of endovascular balloon occlusion methods in the treatment of several cerebrovascular pathologies including AVMs. 39 In the late 1970s, Kerber introduced more distal AVM feeding artery occlusion with liquid embolic agents by using a calibrated leak balloon microcatheter. 40 Exponential advancements in endovascular technologies including microcatheter design and embolisate development was subsequently seen in the 1980s and 1990s.…”