TY - JOUR
T1 - Balloon-augmented carotid artery sacrifice with Onyx
T2 - A proof of concept study in a swine model
AU - Spiotta, Alejandro M.
AU - Sivapatham, Thinesh
AU - Teng, Qingshan
AU - Moskowitz, Shaye I.
AU - Hui, Ferdinand K.
PY - 2011/12/1
Y1 - 2011/12/1
N2 - Introduction: Carotid sacrifice remains a valuable tool in the treatment of select vascular lesions. Neurointerventionalists have relied on coil embolization as their primary means of carotid sacrifice, a procedure that can be lengthy and expensive with long fluoroscopy times. We investigated a novel technique for carotid sacrifice in a swine model using temporary balloon occlusion to achieve proximal flow arrest in the carotid artery while embolizing the vessel with a liquid embolic agent. Methods: A total of 10 common carotid artery sacrifices were performed in pigs under fluoroscopic guidance. Various balloons were employed to achieve near total proximal flow arrest to allow an Onyx cast to accumulate in the target vessel. Results: The technique for sacrifice was modified during the experiment with the final procedures yielding successful sacrifice using Onyx through a dimethylsulfoxide-tolerant catheter (Echelon 14) with the assistance of two fibered coils and a 5 mmx30 mm Hyperglide balloon resulting in a 2.5 cm long cast. Conclusion: Carotid artery sacrifice using commercially available non-adhesive liquid embolic agents is feasible with balloon assistance, allowing for reduced radiation and material costs. Coils may be beneficial in providing an anchor point for liquid embolic deposition, as well as reducing the volume of liquid embolysate required to achieve vessel occlusion.
AB - Introduction: Carotid sacrifice remains a valuable tool in the treatment of select vascular lesions. Neurointerventionalists have relied on coil embolization as their primary means of carotid sacrifice, a procedure that can be lengthy and expensive with long fluoroscopy times. We investigated a novel technique for carotid sacrifice in a swine model using temporary balloon occlusion to achieve proximal flow arrest in the carotid artery while embolizing the vessel with a liquid embolic agent. Methods: A total of 10 common carotid artery sacrifices were performed in pigs under fluoroscopic guidance. Various balloons were employed to achieve near total proximal flow arrest to allow an Onyx cast to accumulate in the target vessel. Results: The technique for sacrifice was modified during the experiment with the final procedures yielding successful sacrifice using Onyx through a dimethylsulfoxide-tolerant catheter (Echelon 14) with the assistance of two fibered coils and a 5 mmx30 mm Hyperglide balloon resulting in a 2.5 cm long cast. Conclusion: Carotid artery sacrifice using commercially available non-adhesive liquid embolic agents is feasible with balloon assistance, allowing for reduced radiation and material costs. Coils may be beneficial in providing an anchor point for liquid embolic deposition, as well as reducing the volume of liquid embolysate required to achieve vessel occlusion.
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U2 - 10.1136/jnis.2011.004697
DO - 10.1136/jnis.2011.004697
M3 - Article
C2 - 21990466
AN - SCOPUS:81155134218
SN - 1759-8478
VL - 3
SP - 390
EP - 394
JO - Journal of neurointerventional surgery
JF - Journal of neurointerventional surgery
IS - 4
ER -