Advanced

AJNR - American Journal of Neuroradiology

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Abud, D. G. Articles by Moret, J. Search for Related Content PubMed PubMed Citation Articles by Abud, D. G. Articles by Moret, J.

American Journal of Neuroradiology 26:2602-2609, November-December 2005
© 2005 American Society of Neuroradiology

INTERVENTIONAL

Venous Phase Timing during Balloon Test Occlusion as a Criterion for Permanent Internal Carotid Artery Sacrifice

Daniel Giansante Abud, Laurent Spelle, Michel Piotin, Charbel Mounayer, Jose Ricardo Vanzin and Jacques Moret

From the Department of Interventional Neuroradiology, Fondation Rothschild, Paris, France

Address correspondence to Laurent Spelle, MD, PhD, Department of Interventional Neuroradiology, Fondation Adolphe de Rothschild, 25-29, rue Manin, 75940 Paris Cedex 19, France

PURPOSE: The purpose of this study was to evaluate the reliability of angiography-based balloon test occlusion (BTO) criteria to decide whether to perform internal carotid artery (ICA) permanent occlusion.

METHODS: From March 1999 to August 2004, 60 patients underwent therapeutic ICA occlusion. Angiographic BTO was performed systematically in all patients under general anesthesia (GA). No clinical examination test was performed. After balloon inflation, contralateral carotid and vertebral arteries angiograms were obtained. The symmetry of the venous phases of each hemisphere was assessed. Occlusion was considered to be feasible when the delay between the venous drainage of the injected and the occluded hemisphere was not >2 seconds. Venous drainage delay >4 seconds was considered as contraindication to ICA permanent occlusion. In patients with venous drainage delay of 2–4 seconds, the occlusion was performed only in selected cases.

RESULTS: From a total of 60 patients, 44 had exact symmetry of the venous phase, 10 had delay of 1 second, and 3 other patients had 2-second delays. Clinical outcome for these 57 patients was uneventful. Three patients had venous drainage delay of 3 seconds. One of them had delayed watershed area infarction without clinical consequences at the time of hospital discharge. No periprocedural complications were observed.

CONCLUSION: Venous opacification symmetry in the tested and control vascular territories was a reliable predictor of a subject’s ability to tolerate carotid occlusion without developing neurologic deficit. Carotid sacrifice was found to be possible when the delay was <3 seconds.

This article has been cited by other articles:

				W S Lesley and R Rangaswamy Balloon test occlusion and endosurgical parent artery sacrifice for the evaluation and management of complex intracranial aneurysmal disease JNIS, December 1, 2009; 1(2): 112 - 120. [Abstract] [Full Text] [PDF]

				W.J. van Rooij and M. Sluzewski Endovascular Treatment of Large and Giant Aneurysms AJNR Am. J. Neuroradiol., January 1, 2009; 30(1): 12 - 18. [Abstract] [Full Text] [PDF]

				A.N. de Gast, M.E. Sprengers, W.J. van Rooij, C. Lavini, M. Sluzewski, and C.B. Majoie Long-Term 3T MR Angiography Follow-Up after Therapeutic Occlusion of the Internal Carotid Artery to Detect Possible de Novo Aneurysm Formation AJNR Am. J. Neuroradiol., March 1, 2007; 28(3): 508 - 510. [Abstract] [Full Text] [PDF]