Department of Neurological Surgery, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.
J Neurointerv Surg. 2011 Dec 1;3(4):390-4. doi: 10.1136/jnis.2011.004697. Epub 2011 Mar 28.
Carotid sacrifice remains a valuable tool in the treatment of select vascular lesions. Neurointerventionalists have relied on coil embolization as their primary means of carotid sacrifice, a procedure that can be lengthy and expensive with long fluoroscopy times. We investigated a novel technique for carotid sacrifice in a swine model using temporary balloon occlusion to achieve proximal flow arrest in the carotid artery while embolizing the vessel with a liquid embolic agent.
A total of 10 common carotid artery sacrifices were performed in pigs under fluoroscopic guidance. Various balloons were employed to achieve near total proximal flow arrest to allow an Onyx cast to accumulate in the target vessel.
The technique for sacrifice was modified during the experiment with the final procedures yielding successful sacrifice using Onyx through a dimethylsulfoxide-tolerant catheter (Echelon 14) with the assistance of two fibered coils and a 5 mm × 30 mm Hyperglide balloon resulting in a 2.5 cm long cast.
Carotid artery sacrifice using commercially available non-adhesive liquid embolic agents is feasible with balloon assistance, allowing for reduced radiation and material costs. Coils may be beneficial in providing an anchor point for liquid embolic deposition, as well as reducing the volume of liquid embolysate required to achieve vessel occlusion.
在治疗某些血管病变时，颈动脉牺牲仍然是一种有价值的工具。神经介入医师依赖线圈栓塞作为颈动脉牺牲的主要手段，该过程可能耗时且昂贵，射线透视时间长。我们研究了一种在猪模型中使用临时球囊闭塞来实现颈动脉近端血流阻断的新型颈动脉牺牲技术，同时使用液体栓塞剂栓塞血管。
在射线透视引导下，对 10 只猪进行了总颈动脉牺牲。使用各种球囊来实现近乎完全的近端血流阻断，以便在目标血管中积累 Onyx 铸型。
在实验过程中，牺牲技术进行了修改，最后使用耐二甲基亚砜的 Echelon 14 导管（Onyx），在两个纤维线圈和一个 5mm×30mm Hyperglide 球囊的协助下，成功进行了牺牲，形成了 2.5cm 长的铸型。
使用市售的非粘附性液体栓塞剂进行颈动脉牺牲是可行的，球囊辅助可减少辐射和材料成本。线圈可能有助于为液体栓塞剂的沉积提供一个锚固点，并减少实现血管闭塞所需的液体栓塞剂的体积。
