scholarly journals The Use of a Double Balloon Catheter for the Balloon Matas Test in Cases of Ostial Stenosis of the Internal Carotid Artery

1993 ◽  
Vol 2 (1) ◽  
pp. 74-76 ◽  
Author(s):  
Takahisa Mori ◽  
Masahiko Arisawa ◽  
Sinya Honda ◽  
Masaaki Fukuoka ◽  
Masahiro Kurisaka ◽  
...  
2017 ◽  
Vol 20 (3) ◽  
pp. 239-246
Author(s):  
Sunil Manjila ◽  
Gagandeep Singh ◽  
Obinna Ndubuizu ◽  
Zoe Jones ◽  
Daniel P. Hsu ◽  
...  

The authors demonstrate the use of an endovascular plug in securing a carotid artery pseudoaneurysm in an emergent setting requiring craniotomy for a concurrent subdural empyema.They describe the case of a 14-year-old boy with sinusitis and bifrontal subdural empyema who underwent transsphenoidal exploration at an outside hospital. An injury to the right cavernous segment of the ICA caused torrential epistaxis. Bleeding was successfully controlled by inflating a Foley balloon catheter within the sphenoid sinus, and the patient was transferred to the authors’ institution. Emergent angiography showed a dissection of the right cavernous carotid artery, with a large pseudoaneurysm projecting into the sphenoid sinus at the site of arterial injury. The right internal carotid artery was obliterated using pushable coils distally and an endovascular plug proximally. The endovascular plug enabled the authors to successfully exclude the pseudoaneurysm from the circulation. The patient subsequently underwent an emergent bifrontal craniotomy for evacuation of a left frontotemporal subdural empyema and exenteration of both frontal sinuses. He made a complete neurological recovery.Endovascular large-vessel sacrifice, obviating the need for numerous coils and antiplatelet therapy, has a role in the setting of selected acute neurosurgical emergencies necessitating craniotomy. The endovascular plug is a useful adjunct in such circumstances as the device can be deployed rapidly, safely, and effectively.


2021 ◽  
Vol 12 ◽  
Author(s):  
Liang Chaohui ◽  
Zhang Guang Yu ◽  
Hou Kai

Objective: To explore the role of balloon-assisted coils technique for ophthalmic segment aneurysms (OSAS).Methods: Clinical data of 30 patients with OSAS were reviewed between December 2017 and December 2018. OSAS were defined as arising from the internal carotid artery (ICA), reaching from the distal dural ring to the origin of the posterior communicating artery. OSAS were classified into four types based on the angiographic findings. The balloon-assisted coils technique was used for the embolization of aneurysms. The duration of balloon inflation cycles, as well as difficulty and complications during the embolization procedure, were recorded. The immediate angiographic results were evaluated according to the Raymond scale. Clinical results were evaluated based on the MRS score. Follow-ups were performed at 18 months post-embolization by DSA or MRA at our institution.Results: Thirty-two aneurysms in 30 patients were detected by digital subtraction angiography (DSA), which included 30 unruptured and two ruptured cases. The patients with ruptured aneurysms were grade II status according to the Hunt-Hess scale. Three cases were type A, nine cases were type B, 17 cases were type C, and three cases were type D. According to aneurysm size, there were 19 cases of small, 11 cases of medium, two cases of large aneurysm. Thirty-two aneurysms were successfully embolized in 30 patients by balloon-assisted coils technique. The ophthalmic artery could be protected by an engorged balloon in the procedure, especially for type A aneurysms. Considering that type D aneurysm arises from the side-wall of the artery and near to tortuous ICA siphon, the balloon catheter was inflated to stabilize the microcatheter allowing for overinflation when necessary. The average duration of balloon dilatation was 4 min, and the average time was 2.5 times. Raymond class was one in 28 aneurysms and two in four aneurysms according to the immediate post-embolization angiographic results. All the patients achieved good clinical effects, except for one patient who presented with brain ischemia resulting in dizziness and contralateral limb weakness for 10 h due to prolonged temporary clamping of the responsible ICA. The follow-up angiography results were satisfactory at 18 months post-embolization.Conclusion: OSAS endovascular treatment with balloon-assisted coils has different advantages in a different classification. The technique is safe, effective, and relatively inexpensive, especially for small and medium OSAS.


2017 ◽  
Vol 126 (3) ◽  
pp. 872-879
Author(s):  
Andrea Ruggeri ◽  
Joaquim Enseñat ◽  
Alberto Prats-Galino ◽  
Antonio Lopez-Rueda ◽  
Joan Berenguer ◽  
...  

OBJECTIVE Neurosurgical management of many vascular and neoplastic lesions necessitates control of the internal carotid artery (ICA). The aim of this study was to investigate the feasibility of achieving control of the ICA through the endoscopic endonasal approach by temporary occlusion with a Fogarty balloon catheter. METHODS Ten endoscopic endonasal paraseptal approaches were performed on cadaveric specimens. A Fogarty balloon catheter was inserted through a sellar bony opening and pushed laterally and posteriorly extraarterially along the paraclival carotid artery. The balloon was then inflated, thus achieving temporary occlusion of the vessel. The position of the catheter was confirmed with CT scans, and occlusion of the ICA was demonstrated with angiography. The technique was performed in 2 surgical cases of pituitary macroadenoma with cavernous sinus invasion. RESULTS Positioning the Fogarty balloon catheter at the level of the paraclival ICA was achieved in all cadaveric dissections and surgical cases through a minimally invasive, quick, and safe approach. Inflation of the Fogarty balloon caused interruption of blood flow in 100% of cases. CONCLUSIONS Temporary occlusion of the paraclival ICA performed through the endoscopic endonasal route with the aid of a Fogarty balloon catheter may be another maneuver for dealing with intraoperative ICA control. Further clinical studies are required to prove the efficacy of this method.


2015 ◽  
Vol 21 (3) ◽  
pp. 390-396 ◽  
Author(s):  
Ljubisa Borota ◽  
Ehab Mahmoud ◽  
Christoffer Nyberg ◽  
Tomas Ekberg

Juvenile nasal angiofibroma (JNA) is a hypervascularised, benign, but locally aggressive tumour that grows in the posterior, upper part of the nasal cavity and invades surrounding anatomical structures. The treatment of choice is surgical removal, but complete resection of the tumour can be hampered because of profuse perioperative bleeding. Preoperative embolisation of the tumour has been proposed as an effective method for prevention of perioperative bleeding, thereby shortening of the time of the operation. In this report of five cases, we describe successful preoperative devascularisation of the tumour by applying a modified method of direct intratumoural injection of the liquid embolic agent Onyx combined with protection of the internal carotid artery. The control of bleeding during the embolisation and occlusion of the maxillary or sphenopalatine artery was achieved by using a bi-luminal balloon catheter. Such use of the dual-lumen catheter in treatment of JNA has not been reported so far in the medical literature.


2018 ◽  
Vol 24 (3) ◽  
pp. 317-321 ◽  
Author(s):  
Akitake Okamura ◽  
Kazuhiko Kuroki ◽  
Katsuhiro Shinagawa ◽  
Naoto Yamada

Background In cases of acute ischemic stroke, manual aspiration of the thrombus is commonly performed with a balloon guiding catheter placed in the cervical segment of the internal carotid artery (ICA). However, most manual aspirations using a balloon guiding catheter are combined with inner catheters, as in the direct aspiration first pass technique (ADAPT). We experienced some cases of acute ischemic stroke with proximal ICA occlusion due to cardiogenic thrombus where we obtained sufficient recanalization by simple manual aspiration from inflated Optimo 9F balloon catheters (Tokai Medical Products, Japan) placed in the origin of the cervical segment of the ICA without any inner catheter or stent retriever. We perform by preference this procedure, named the simple Aspiration with Balloon Catheter (simple ABC) technique. Herein, we report two recent cases and discuss this procedure. Case presentation Case 1: An 80-year-old man with paroxysmal atrial fibrillation developed left ICA occlusion. We performed the simple ABC technique and obtained a large amount of dark red and white thrombus. Puncture-to-reperfusion time was 14 minutes with Thrombolysis in Cerebral Infarction (TICI) grade 3. Case 2: A 69-year-old man with chronic atrial fibrillation developed left internal carotid occlusion. We performed the simple ABC technique and obtained a large amount of dark red thrombus. Puncture-to-reperfusion time was 15 minutes with TICI grade 2b. Conclusion The simple ABC technique is useful to deal with a large amount of thrombus, shortens procedure time, enables less invasive thrombectomy, and can shift immediately to subsequent procedures such as delivering a stent retriever or ADAPT.


1989 ◽  
Vol 103 (12) ◽  
pp. 1202-1205 ◽  
Author(s):  
M. Jacobsson ◽  
Å. Davidsson ◽  
S. Hugosson ◽  
A. Tjellström ◽  
P. Svendsen

AbstractA case is presented of a 3-year-old girl with no previous history of ear disease or developmental defects who bled profusely upon (right) myringotomy. The haemorrhage could only be stopped with the aid of an ear insert and a nasopharyngeal balloon catheter. The balloon catheter was removed the following day but the girl had to use an ear insert for a total of 76 days following myringotomy because of repeated haemorrhage from the ear. The subsequent investigation using CT and angiography revealed an aberrant internal carotid artery in the middle ear.It is concluded that the one most important factor in the handling of these cases is to be aware of the existence of aberrant internal carotid arteries and to have a high degree of suspicion when encountering any abnormal clinical or radiological findings which might point in the direction of vascular abnormalities. The failure to detect this condition before any surgical intervention on the affected ear can have disastrous consequences.The method of choice in handling these cases is one of avoidance of middle ear manipulation in order not to cause haemorrhage from the aberrant artery.


Vascular ◽  
2005 ◽  
Vol 13 (4) ◽  
pp. 248-251 ◽  
Author(s):  
Nenad S. Ilijevski ◽  
Sinisa Jagodic ◽  
Dragan Sagic ◽  
Djordje Radak

Coiling (or looping) of the artery is a rare morphologic entity, most frequently described in the internal carotid artery. In other arteries, coiling is rarely reported because it remains asymptomatic and without clinical relevance unless inadvertently injured, as for diagnostic or monitoring purposes. We present a case of an unusually difficult thrombectomy of the brachial artery after occlusion following withdrawal of the arterial cannula placed for monitoring during cardiac surgery owing to coiling of the distal part of the artery, which produced the “spring-squeeze phenomenon” during balloon catheter thrombectomy.


1997 ◽  
Vol 3 (2_suppl) ◽  
pp. 190-193
Author(s):  
A. Kurashima ◽  
A. Otuka ◽  
T. Saito ◽  
T. Tuchiya ◽  
T. Uzuka ◽  
...  

We performed emergency percutaneous transluminal angioplasty (PTA) with a perfusion balloon catheter (PBC) for PTCA and, at the same time, thrombolytic therapy was administered by urokinase (UK) perfusion in five cases of severe cervical internal carotid artery stenosis in which sudden cerebral hemisphere ischemia occurred due to acute thrombotic obliteration. In four out of the five cases, effective revascularization was obtained; three resulted in Good recovery, but one showed extensive cerebral infarction after PTA. In the remaining one case, where stenosis of the internal carotid artery of the opposite side occurred subclinically, effective revascularization by PTA was impossible resulting in the death of this patient. While “artery to aetery embolism” was confirmed in all four cases in which revascularization was successful, most emboli were dissolved by combined thrombolysis. As poor prognostic factors, findings of a low density area and closing of cerebral sulci in an initial CT and poor development of the collateral circulation mediating the circle of Willis and leptomeningeal collateral on the cerebral surface were indicated. Since PBC is capable of performing PTA while assuring circulation distant from the balloon, it facilitates gradual and prolonged balloon inflation, which is said to be safer and more effective, and is considered a reasonable method of revascularization at the time of an acute obliteration in the cervical internal carotid artery. In addition, this method can be used as a bridge to carotid endarterectomy. However, “artery to artery embolism” accompanying PTA in the acute stage remains a major problem, and a combination of thrombolysis seems indispensable.


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