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Case Reports
. 2022 Jan;164(1):169-172.
doi: 10.1007/s00701-021-05074-w. Epub 2021 Dec 1.

Super-selective balloon test occlusion with electrophysiological monitoring to occlude angiographically invisible posterior communicating artery perforators with unruptured aneurysm

Daisuke Maruyama  1   2 , Masataka Nanto  3 , Shogo Ogita  3 , Kengo Kishida  4 , Gaku Fujiwara  4 , Mamoru Murakami  4 , Nobukuni Murakami  4 , Naoya Hashimoto  3
Affiliations
Case Reports

Super-selective balloon test occlusion with electrophysiological monitoring to occlude angiographically invisible posterior communicating artery perforators with unruptured aneurysm

Daisuke Maruyama et al. Acta Neurochir (Wien). 2022 Jan.

Abstract

Balloon test occlusion (BTO) can predict the ischemic complication risk associated with arterial occlusion. We present a case of an unruptured, broad-necked internal carotid artery-posterior communicating artery (PcomA) aneurysm that was successfully embolized after super-selective BTO of fetal PcomA with electrophysiological monitoring. The proximal portion of the PcomA was internally occluded without causing major neurological deficits, although we observed a small new infarction in the ipsilateral anterior thalamus postoperatively. We recognized small perforators arising from the proximal PcomA during a previous clipping surgery. Super-selective BTO with electrophysiological monitoring could be useful for functional preservation after infarction from angiographically invisible perforators.

Keywords: Balloon test occlusion; Endovascular treatment; Ischemic complication risk; Posterior communicating artery.

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