RISK-FACTORS LEADING TO CEREBRAL ARTERIAL RUPTURE BY INTRAVASCULAR BALLOON

PURPOSE: To clarify what is safe use of balloons in interventional neu roradiologic procedures. METHODS: Critical parameter values of balloon inflation and cerebral artery dilatation and rupture were determined. Dimensions and internal pressure were measured for a variety of latex and silicone balloons during inflation in both unconstrained and cons trained environments including glass tubes, cadaveric human cerebral a rteries, and canine basilar arteries. RESULTS: For unconstrained infla tion, pressures within balloons inflated to the recommended maximum vo lume ranged from 200 to 650 mm Hg. When constrained, pressures became much higher for the same injected fluid volume. Balloon dilatation unt il artery rupture occurred only for balloons with diameters greater th an 2.5 times the unstretched vessel diameter. Balloon pressures at ves sel rupture ranged from 1000 to 2000 mm Hg. CONCLUSION: Pressures with in inflated balloons vary with balloon type, material, degree of infla tion, and constraint. Constrained balloons have markedly higher intern al pressures, which may lead to vessel rupture if balloons are much la rger than the vessel diameter.