Occlusion of M1 segment after superficial temporal artery-middle cerebral artery bypass in a giant M1 aneurysm with Onyx-34 injected via a double-lumen balloon under balloon inflation

A 29-year-old patient attended our institution for recurrent strokes related to a giant partially thrombosed M1 aneurysm. Superficial temporal artery-middle cerebral artery (STA-MCA) bypass and subsequent occlusion of both the aneurysm and the dysplastic M1 segment were planned. However, owing to th...

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Bibliographic Details
Published in:BMJ case reports 2013-05, Vol.2013, p.bcr2013010738
Main Authors: Clarençon, Frédéric, Nouet, Aurelien, Redondo, Aimée, Di Maria, Federico, Iosif, Christina, Le Jean, Lise, Chiras, Jacques, Sourour, Nader
Format: Article
Language:English
Subjects:
Acquisitions & mergers
Adult
Aneurysms
Angioplasty, Balloon
Blood clots
Carotid arteries
Humans
Intracranial Aneurysm - surgery
Male
Middle Cerebral Artery - surgery
New Devices
Stents
Temporal Arteries - surgery
Thrombosis
Treatment Outcome
Veins & arteries
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Summary:A 29-year-old patient attended our institution for recurrent strokes related to a giant partially thrombosed M1 aneurysm. Superficial temporal artery-middle cerebral artery (STA-MCA) bypass and subsequent occlusion of both the aneurysm and the dysplastic M1 segment were planned. However, owing to the shortness of the non-dysplastic segment of M1 and the risk of occlusion of the lenticulostriate arteries, the use of a double-lumen balloon was considered for coiling and subsequent injection of Onyx. STA-MCA bypass was performed using a regular technique. Endovascular occlusion of both the aneurysm and the parent artery was subsequently performed by means of coils and Onyx-34 that was injected via the Ascent balloon under balloon inflation. No complications were recorded and no stroke was observed on control MRI. The injection of Onyx-34 through a double-lumen balloon under balloon inflation is a quick and safe technique for precise occlusion of a parent artery.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2013-010738