Meyers P M, Thakur G A, Tomsick T A
Department of Radiology, University of California, San Francisco, USA.
AJNR Am J Neuroradiol. 1999 Apr;20(4):559-64.
Temporary balloon occlusion has become a routine and medically accepted technique for the management of patients with aneurysms or intracranial or head/neck tumors. We describe our experience using a nondetachable silicone balloon (NDSB) catheter in 103 endovascular temporary balloon occlusions of the internal carotid artery, with attention focused on technique, complications, and cost.
Between 1993 and 1998, 103 patients underwent preoperative temporary balloon occlusion testing with a 1.5-mm NDSB catheter. Clinical testing during endovascular blockade was combined with qualitative cerebral blood flow analysis using technetium-99m HMPAO SPECT. Cost-effective analysis was performed, emphasizing cost and complication rates in comparison with those in previously reported series in which multiple types of temporary balloon occlusion catheters were used, predominantly not of the NDSB type.
No carotid artery injury or complication, including cerebral infarction due to NDSB use, was encountered. Despite the increased cost of the NDSB catheter system, cost-effective analysis showed up to 40% reduction in cost per quality adjusted life years.
Temporary balloon occlusion using the NDSB catheter is safe and cost-effective, owing to the low rate of complications.
临时球囊闭塞术已成为治疗动脉瘤、颅内或头颈部肿瘤患者的常规且被医学认可的技术。我们描述了在103例颈内动脉血管内临时球囊闭塞术中使用不可拆卸硅胶球囊（NDSB）导管的经验，重点关注技术、并发症和成本。
1993年至1998年间，103例患者使用1.5毫米NDSB导管进行术前临时球囊闭塞测试。血管内阻断期间的临床测试与使用锝-99m HMPAO SPECT进行的定性脑血流分析相结合。进行了成本效益分析，重点比较了与先前报道系列（主要使用多种类型的临时球囊闭塞导管，主要不是NDSB类型）相比的成本和并发症发生率。
未遇到颈动脉损伤或并发症，包括因使用NDSB导致的脑梗死。尽管NDSB导管系统成本增加，但成本效益分析显示每质量调整生命年的成本降低了40%。
由于并发症发生率低，使用NDSB导管进行临时球囊闭塞术是安全且具有成本效益的。
