Endovascular occlusion of the carotid or vertebral artery with temporary proximal flow arrest and microcoils: clinical results.
OBJECTIVE
To determine the clinical effectiveness of parent artery occlusion of the carotid or vertebral artery by means of temporary proximal flow arrest and microcoils.


METHODS
Nineteen parent artery occlusions (15 carotid, four vertebral) were performed in 19 patients who successfully passed a balloon test occlusion. In these patients, endovascular occlusion of the carotid or vertebral artery was accomplished with the use of temporary proximal flow arrest and microcoils.


RESULTS
All 19 parent arteries were occluded. Eighteen patients (95%) had good outcomes and one (5%) had a poor outcome. Fourteen patients (74%) had no complications and five (26%) had complications, of whom only one was left with a permanent neurologic deficit. Three (60%) of the complications were the result of delayed ischemic events after parent artery occlusion and were not predicted by balloon test occlusion.


CONCLUSIONS
Endovascular occlusion with temporary proximal flow arrest and microcoils can be done effectively and successfully. The predictive value of the balloon test occlusion is the major complicating factor, as it is with balloon occlusion. This technique offers an additional tool that can be used for endovascular occlusion of the carotid or vertebral artery and seems to be less difficult technically. It is our primary technique for parent artery occlusion.
Graves
V B
VB
Department of Radiology, University of Wisconsin, Madison 53792, USA.
Perl
J
J
Strother
C M
CM
Wallace
R C
RC
Kesava
P P
PP
Masaryk
T J
TJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000628:therapy*; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000628:therapy*; D001921:Brain / Q000098:blood supply; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000209:etiology; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D002426:Cavernous Sinus / Q000000981:diagnostic imaging; D002533:Cerebral Angiography; D002544:Cerebral Infarction / Q000000981:diagnostic imaging / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D003097:Collateral Circulation / Q000502:physiology; D004621:Embolization, Therapeutic / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014711:Vertebral Artery / Q000000981:diagnostic imaging