EMBOLIZATION OF CEREBRAL ANEURYSMS WITH A LIQUID EMBOLUS, EVAL MIXTURE - REPORT OF 3 CASES

Embolization of three surgically difficult cerebral aneurysms was perf ormed using our newly developed non-adhesive embolic material, EVAL mi xture (ethylene vinyl alcohol copolymer). Conventional embolic materia ls such as detachable balloons or microcoils were not used because of a large or irregular aneurysmal neck. After temporary occlusion of the parent artery with a superselective balloon catheter, the EVAL mixtur e was slowly injected through a microcatheter placed in the aneurysm o r parent artery. The locations of the aneurysms were anterior communic ating artery, basilar artery-posterior cerebral artery and basilar art ery-anterior inferior cerebellar artery (BA-AICA). One aneurysmal occl usion and 2 parent artery occlusions were performed. Patients had no p ersistent deficits. The patient with the BA-AICA aneurysm associated w ith an arteriovenous malformation died of rupture of the residual AVM due to haemodynamic change 2 weeks after embolization. In selected and limited cases, embolization of surgically difficult cerebral aneurysm s using EVAL mixture was more effective and safer than embolization us ing conventional embolic materials such as balloons and microcoils.