RT Journal Article
SR Electronic
T1 Aneurysmal Pressure Changes with Nondetachable Balloon Placement and Fluid Infusion: Rationale for Liquid Embolization
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1232
OP 1236
VO 26
IS 5
A1 Steven G. Imbesi
A1 Kimberly Knox
A1 Charles W. Kerber
YR 2005
UL http://www.ajnr.org/content/26/5/1232.abstract
AB BACKGROUND AND PURPOSE:To improve the safety and efficacy of liquid embolization, we evaluated changes in pressures in experimental aneurysms.METHODS:We created three replicas of a lateral sidewall aneurysm and placed them in a physiologic flow circuit. A 3 × 10-mm nondetachable balloon was positioned in the parent vessel across the aneurysmal neck. Intra-aneurysmal pressures were measured at baseline and after balloon inflation. Fluid was infused into the sac via a 1.45F microcatheter during inflation, and maximal pressures were noted. Measurements were repeated eight times in each aneurysm.RESULTS: After balloon inflation, average intra-aneurysmal pressures increased: 12 mm Hg (13%, σn − 1 = 0.46) for aneurysm 1 (baseline mean arterial pressure [MAP], 94 mm Hg), 15 mm Hg (58%, σn − 1 = 0.88) for aneurysm 2 (baseline MAP, 26 mm Hg), and 15 mm Hg (58%, σn − 1 = 0.92) for aneurysm 3 (baseline MAP, 26 mm Hg). During inflation and infusion, pressures increased slightly: 1.1 (0.94%, σn − 1 = 0.64), 1.6 (3.9%, σn − 1 = 1.1), and 1.9 (4.6%, σn − 1 = 1.2) mm Hg for aneurysms 1, 2, and 3, respectively. Despite complete balloon occlusion of the distal aneurysmal neck, a channel between the proximal aneurysmal neck and the parent-vessel lumen persisted along the microcatheter. Fluid exited the sac via this channel, preventing a concomitant, significant increase in pressure during infusion.CONCLUSION: Intra-aneurysmal pressure modestly increased with inflation of a parent-vessel balloon across the neck. When liquid was infused into the sac during inflation, further increases were minimal.