Suction decompression methods for giant internal carotid ophthalmic aneurysms by using revised double lumen balloon catheters

Abstract

In giant, large internal carotid ophthalmic artery aneurysms, revised double lumen balloon catheters introduced directly into the cervical carotid arteries were used successfully to perform suction decompression methods. No general heparinization was used during these maneuvers except for continuous intraluminal irrigation of heparin contained saline. Intraoperative multi-directional portable DSA ascertained complete neck clippings and patency of parent vessels. These methods were tried for 8 cases of large, giant IC ophthalmic aneurysms. Among these 5 patients who complained of incomplete visual failures, visual acuity improved in 3 cases. Postoperative transient hemiparesis were seen in two cases which had partially thrombosed, calcified giant aneurysm and the other was due to prolonged proximal ICA occlusion at its cavernous portion. Neither dead nor severely disabled cases were seen, fortunately. Delayed postoperative conventional angiography disclosed complete neck clippings sparing parent arteries except for only one case. This revised direct carotid puncture method is simple and acceptable because of minimal morbidity.