Temporary endovascular balloon occlusion of the internal carotid artery with a nondetachable silicone balloon catheter: Analysis of technique and cost

BACKGROUND AND PURPOSE: Temporary balloon occlusion has become a routine an d medically accepted technique for the management of patients with aneurysm s or intracranial or head/neck tumors. We describe our experience using a n ondetachable silicone balloon (NDSB) catheter in 103 endovascular temporary balloon occlusions of the internal carotid artery, with attention focused on technique, complications, and cost. METHODS: Between 1993 and 1998, 103 patients underwent preoperative tempora ry balloon occlusion testing with a 1.5-mm NDSB catheter, Clinical testing during endovascular blockade was combined with qualitative cerebral blood f low analysis using technetium-99m HMPAO SPECT, Cost-effective analysis was performed, emphasizing cost and complication rates in comparison with those in previously reported series in which multiple types of temporary balloon occlusion catheters were used, predominantly not of the NDSB type. RESULTS: No carotid artery injury or complication, including cerebral infar ction due to NDSB use, was encountered. Despite the increased cost of the N DSB catheter system, cost-effective analysis showed up to 40% reduction in cost per quality adjusted life years. CONCLUSION: Temporary balloon occlusion using the NDSB catheter is safe and cost-effective, owing to the low rate of complications.