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

• 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
• ISSN: 1757-790X; 1757-790X
• DOI: 10.1136/bcr-2013-010738

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.