Ansari Ahmed, Ohshima Tomotaka, Goto Shunsaku, Yamamoto Taiki, Ishikawa Kojiro, Kato Yoko
Department of Neurosurgery, Fujita Health University, Banbuntane Hotokukai Hospital, Nagoya, Japan.
Department of Neurosurgery and Stroke, Kariya Toyota General Hospital, Nagoya, Japan.
Asian J Neurosurg. 2019 Jul-Sep;14(3):873-877. doi: 10.4103/ajns.AJNS_134_17.
Endovascular treatment of complex ruptured aneurysms in the internal carotid (IC) artery is extremely challenging. Navigation of double-balloon catheters becomes all the more difficult in tortuous vessels.
A 57-year-old female with more than three times previously ruptured left IC artery aneurysm with subarachnoid hemorrhage had a left IC small aneurysm with a neck of 3.2 mm. Proximal and distal balloons were inflated in left IC artery in respect to the aneurysm, to prevent further rupture during navigation of the microcatheter and first coil.
The technique uses two balloons placed proximal and distal to the ruptured aneurysm, to reduce further bleeding, just as the application of temporary clips, followed by inertion of coils rapidly to obliterate the aneurysm.
It is a novel technique of double-balloon trapping of proximal and distal segment of IC artery with aneurysm coiling technique as an alternative to balloon-assisted coiling and stent-assisted coiling in patients with ruptured aneurysm.
颈内动脉复杂破裂动脉瘤的血管内治疗极具挑战性。在迂曲血管中操作双球囊导管会变得更加困难。
一名57岁女性，既往有三次以上左侧颈内动脉动脉瘤破裂伴蛛网膜下腔出血病史，此次发现左侧颈内动脉有一个颈部为3.2毫米的小动脉瘤。在动脉瘤的近端和远端对左侧颈内动脉进行球囊充盈，以防止在微导管和首个弹簧圈置入过程中进一步破裂。
该技术通过在破裂动脉瘤的近端和远端放置两个球囊来减少进一步出血，这与应用临时夹闭类似，随后迅速置入弹簧圈以闭塞动脉瘤。
这是一种采用双球囊封堵颈内动脉近端和远端节段并结合动脉瘤弹簧圈栓塞技术的新技术，可作为破裂动脉瘤患者球囊辅助弹簧圈栓塞和支架辅助弹簧圈栓塞的替代方法。
