Detachable balloonによる脳動脈瘤内塞栓術の合併症

Abstract

Between 1987 and 1991, 14 patients with cerebral aneurysm were treated by endovascular detachable balloon embolization technique. A detachable latex balloon was directly guided into the aneurysm, inflated with silicone or contrast material and detached.The patients ranged in age from 28 to 69 years (mean age, 48) and consisted of 9 males and 5 females. Five aneurysms distributed in the anterior circulation and 9 in the posterior circulation. Six of the aneurysms were small (<10mm), 7 large (10< <25mm), and 1 giant (25mm<). Nine patients presented with subarachnoid hemorrhage, 4 with mass effect and 1 without symptom.In 3 patients the parent arteries as well as the aneurysm were occluded. In 11 patients direct balloon embolizations were achieved with preservation of the parent arteries.Complications associated directly with balloon embolization therapy included 3 ruptures of the aneurysms that occured as a result of incomplete occlusion in 2 and slight overinflation of balloon in 1. One aneurysm ruptured at 4 months and 2 within 1 day after treatment. Two patients died of subarachnoid hemorrhage and 1 developed carotid-cavernous sinus fisutula that was treated by detachable balloon technique with good outcome.After balloon embolization therapy, 2 patients developed stroke due to narrowing of parent arteries. One patient had Weber's syndrome and another had hemiparesis.