TEMPORARY BALLOON PROTECTION AS AN ADJUNCT TO ENDOSACCULAR COILING OFWIDE-NECKED CEREBRAL ANEURYSMS - TECHNICAL NOTE

OBJECTIVE: We present an endovascular technique for treating wide-neck ed cerebral aneurysms using Guglielmi detachable coils (Target Therape utics, Fremont, CA) and simultaneous temporary balloon protection. The temporary balloon serves as a mechanical external force to mold the m icrocoils away from the parent artery. METHODS: Two illustrative cases of wide-necked cerebral aneurysms treated with Guglielmi detachable c oils and a temporary balloon are presented. Emphasis is placed on the technical aspects of the approach, with several variations. The first case involves a left posterior cerebral artery aneurysm at the P1/P2 s egment, and the second case involves a left paraclinoid internal carot id artery aneurysm. Both patients suffered from subarachnoid hemorrhag e, but neither was a candidate for craniotomy. In each case, the coils , when used alone, protruded into the parent artery and were therefore removed. Then a temporary balloon was inflated for mechanical protect ion during coil deployment. RESULTS: The use of simultaneous temporary balloon protection allowed more dense intra-aneurysmal coil packing, especially in the neck, without parent artery compromise, than did the use of Guglielmi detachable coils alone. CONCLUSION: Endovascular tre atment of wide-necked cerebral aneurysms can be facilitated by simulta neous temporary balloon protection.