FIG 3. A, Detachable silicone balloon securely placed (open arrow) just prior to inflation of a nondetachable balloon (arrowheads) precludes migration of detachable balloon into the carotid.

B, Diagrammatic representation of placement of the detachable balloon within the cavernous sinus, followed by inflation and sealing of the fistula with positioning of the nondetachable balloon at the defect in the vessel. Finally, the balloon is detached only after inflation of the nondetachable balloon within the carotid, effectively precluding migration and errant embolization of the detachable balloon into the internal carotid artery.