scholarly journals Balloon Test Occlusion for an Option to Decide Whether Simple ICA Ligation is Better Option than Trapping and High Flow Bypass of The Giant ICA Cavernous Aneurysm

2017 ◽  
Vol 14 (2) ◽  
pp. 32-35
Author(s):  
Saujanya Rajbhandari ◽  
Pravesh Rajbhandari ◽  
Pranaya Shrestha ◽  
Basant Pant ◽  
Anish Neupane
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Cross Flow ◽  
Balloon Occlusion ◽  
High Flow ◽  
Aneurysm Neck ◽  
Balloon Test Occlusion ◽  
Therapeutic Occlusion ◽  
Temporary Balloon Occlusion

Balloon Test occlusion (BTO) is a preoperative angiographic test used to estimate the risk of stroke after permanent therapeutic occlusion of an internal carotid artery (ICA) involved by aneurysms. Temporary balloon occlusion at the cavernous ICA aneurysm neck was performed in an attempt to assess the adequacy of cross flow from the opposite ICA. Adequate fl ow following BTO are preferred to have simple ICA ligation and incase of those who did not pass BTO trapping and high flow bypass is preferred .We have done Right ICA Ligation on our case report.Nepal Journal of Neuroscience, Vol. 14, No. 2,  2017 Page:32-35

scholarly journals Reversal of severe SPECT asymmetry after venous extra-intracranial high flow bypass in a patient submitted to therapeutic internal carotid occlusion: case report

2001 ◽  
Vol 59 (3B) ◽  
pp. 797-801 ◽  
Author(s):  
Jorge Marcondes ◽  
Antônio Aversa ◽  
Marcio Peçanha ◽  
Flávio Domingues ◽  
Fernanda Nascimento ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Single Photon ◽  
Photon Emission ◽  
High Flow ◽  
Carotid Occlusion ◽  
Balloon Test Occlusion ◽  
Vein Bypass ◽  
Therapeutic Occlusion

Therapeutic occlusion of the internal carotid artery is the main option for the treatment of the symptomatic intracavernous internal carotid artery aneurysms, but the issue of the best way of doing the balloon test occlusion (BTO) regarding prediction of future ischemic events remains debatable. Single photon emission computerized tomography (SPECT) has been offered as one of the best option of monitoring regional cerebral blood flow (rCBF) during the BTO, where severe asymmetry is predictive of delayed ischemia. We describe a case of important SPECT asymmetry during BTO clinically negative and its complete reversal with carotid occlusion after extra-intracranial bypass with high flow safenous vein bypass between the cervical carotid artery and the middle cerebral artery.

Hemodynamic Compensation via an Excimer Laser-assisted, High-flow Bypass before and after Therapeutic Occlusion of the Internal Carotid Artery

Neurosurgery ◽  
2003 ◽  
Vol 53 (4) ◽  
pp. 858-865 ◽  
Author(s):  
Jeroen Hendrikse ◽  
Albert van der Zwan ◽  
Lino M.P. Ramos ◽  
Cees A.F. Tulleken ◽  
Jeroen van der Grond
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Basilar Artery ◽  
Bypass Surgery ◽  
Internal Carotid ◽  
High Flow ◽  
Volume Flow ◽  
Giant Aneurysms ◽  
Flow Through ◽  
Therapeutic Occlusion

Abstract OBJECTIVE High-flow, extracranial-intracranial (EC-IC) bypass operations are performed to prevent strokes among patients with giant aneurysms who cannot tolerate internal carotid artery (ICA) occlusion. However, the volume flow through the bypass, compared with preoperative ICA flow, has not been evaluated for any type of bypass. We describe a prospective case study that tested the ability of the high-flow EC-IC bypass to replace the volume flow of the ipsilateral ICA after deliberate ICA occlusion. METHODS Seven consecutive patients with giant aneurysms of the ICA who experienced test occlusion failure underwent nonocclusive, excimer laser-assisted, EC-IC bypass surgery before permanent ICA occlusion. Volume flow values in the ICAs, the basilar artery, the EC-IC bypass, and the middle cerebral arteries were measured with magnetic resonance angiography. RESULTS No significant changes in volume flow to the ipsilateral and contralateral hemispheres were observed after bypass surgery and therapeutic ICA occlusion. Before bypass surgery, the volume flow through the ipsilateral ICA was 243 ± 74 ml/min, that through the contralateral ICA was 264 ± 32 ml/min, and that through the basilar artery was 141 ± 43 ml/min. After bypass surgery and therapeutic occlusion of the ipsilateral ICA, the volume flow through the bypass was 199 ± 72 ml/min, that through the contralateral ICA was 303 ± 82 ml/min, and that through the basilar artery was 153 ± 72 ml/min. No significant preoperative versus postoperative changes in middle cerebral artery flow were observed on either side. CONCLUSION The flow through the high-flow EC-IC bypass was able to replace the volume flow of the ipsilateral ICA after deliberate ICA occlusion for the treatment of giant aneurysms.

scholarly journals Giant Aneurysm of the Cervical Internal Carotid Artery Treated by Proximal Coil Embolization under Temporary Balloon Occlusion

2001 ◽  
Vol 7 (4) ◽  
pp. 331-335 ◽  
Author(s):  
A. Uchino ◽  
Y. Takase ◽  
T. Koizumi ◽  
S. Kudo
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Giant Aneurysm ◽  
Balloon Occlusion ◽  
Partial Filling ◽  
Coil Occlusion ◽  
Platinum Coils ◽  
Temporary Balloon Occlusion ◽  
Cervical Internal Carotid Artery

We report a patient with a giant aneurysm on the left cervical internal carotid artery (ICA) treated successfully by proximal coil occlusion. Fibered platinum coils were delivered via a 5-F catheter under temporary balloon occlusion of the proximal ICA and without complications. MR imaging ten months after the procedure showed the aneurysm to be reduced in size and subtotally thrombosed. Retrograde partial filling of the aneurysmal lumen was present, however. We describe the case in detail and discuss the ideal treatment of the cervical ICA aneurysm.

Cavernous sinus embolisation prior to removal of penetrating foreign body in a 6-year-old child

2020 ◽  
Vol 13 (12) ◽  
pp. e237301
Author(s):  
Kartik D Bhatia ◽  
Heath French ◽  
Gemma Olsson ◽  
Krishna Tumuluri
Keyword(s):  
Foreign Body ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cavernous Sinus ◽  
Internal Carotid ◽  
Arterial Injury ◽  
Balloon Occlusion ◽  
Parent Vessel ◽  
Intraoperative Bleeding ◽  
Temporary Balloon Occlusion

Transorbital penetrating foreign bodies are extremely rare in children and may penetrate the cavernous sinus or the underlying internal carotid artery. Parent vessel sacrifice and temporary balloon occlusion are feasible options for managing arterial injury during removal of the foreign body. Even in the absence of arterial injury, the ophthalmologist may encounter significant bleeding from the cavernous sinus deep in their operative field that is difficult to control. We present a case of a 6-year-old child with a stick penetrating the left superior orbit to enter the cavernous sinus but sparing the internal carotid artery. We describe the first reported experience of prophylactic coil embolisation of the cavernous sinus to minimise intraoperative bleeding during transorbital removal of a foreign body with an excellent clinical outcome.

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