Temporary balloon protection as an adjunct to endosaccular coiling of wide-necked cerebral aneurysms: technical note.
OBJECTIVE
We present an endovascular technique for treating wide-necked cerebral aneurysms using Guglielmi detachable coils (Target Therapeutics, Fremont, CA) and simultaneous temporary balloon protection. The temporary balloon serves as a mechanical external force to mold the microcoils away from the parent artery.


METHODS
Two illustrative cases of wide-necked cerebral aneurysms treated with Guglielmi detachable coils and a temporary balloon are presented. Emphasis is placed on the technical aspects of the approach, with several variations. The first case involves a left posterior cerebral artery aneurysm at the P1/P2 segment, and the second case involves a left paraclinoid internal carotid artery aneurysm. Both patients suffered from subarachnoid hemorrhage, but neither was a candidate for craniotomy. In each case, the coils, when used alone, protruded into the parent artery and were therefore removed. Then a temporary balloon was inflated for mechanical protection during coil deployment.


RESULTS
The use of simultaneous temporary balloon protection allowed more dense intra-aneurysmal coil packing, especially in the neck, without parent artery compromise, than did the use of Guglielmi detachable coils alone.


CONCLUSIONS
Endovascular treatment of wide-necked cerebral aneurysms can be facilitated by simultaneous temporary balloon protection.
Mericle
R A
RA
Department of Neurosurgery, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, USA.
Wakhloo
A K
AK
Rodriguez
R
R
Guterman
L R
LR
Hopkins
L N
LN
D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000628:therapy*; D015901:Angiography, Digital Subtraction; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000628:therapy; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D002404:Catheterization / Q000295:instrumentation*; D002533:Cerebral Angiography; D002540:Cerebral Cortex / Q000098:blood supply*; D004621:Embolization, Therapeutic / Q000295:instrumentation*; D004867:Equipment Design; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000628:therapy*; D012039:Regional Blood Flow / Q000502:physiology; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging / Q000628:therapy*