[A successful treatment of giant carotid artery aneurysm by a detachable balloon technic; a child case]

Abstract

For the treatment of unclippable giant carotid artery aneurysms, proximal occlusion of the carotid artery is still an accepted treatment by surgical ligation, Selverstone clamp, or detachable balloon. However, proximal artery occlusion should be avoided as far as possible. Use of detachable balloons for proximal artery occlusion in the treatment of giant intracranial aneurysm in children has been reported by several authors, but no report of successfully treated cases of occlusion of the aneurysm without occlusion of the parent artery can be found. On January 1st, 1987, a-5-year old girl was admitted to our clinic with chief complaints of exophthalmos and loss of vision in her left eye. On admission, neurological examination showed palsies of the left oculomotor and abducens nerve and left internal carotid angiogram visualized a giant aneurysm in the cavernous portion. A balloon catheter procedure was carried out under general anesthesia using an intra-arterial catheter technique. A No. 9 French introducer catheter was placed through the femoral artery sheath. No filling of aneurysm without occlusion of the parent artery could be confirmed by angiogram. No. 12 Debrun detachable balloon was then detached. Postoperative course was uneventful. Subsequently, her oculomotor and abducens nerve palsies disappeared. Digital subtraction angiography taken about three months after the procedure showed complete occlusion of the aneurysm. The authors emphasized that the occlusion of the aneurysm using a detachable balloon was also the ideal method for the treatment of the children's giant aneurysm.