Use of coils for transcatheter carotid occlusion.

The preferred treatment of various internal carotid aneurysms deemed surgically inaccessible involves the occlusion of the carotid artery with subsequent thrombosis of the aneurysm. Carotid occlusion can be accomplished surgically either by abrupt ligation or with the use of a controlled gradual occlusive device such as a Selverstone clamp [1 , 2]. Recently a transcatheter detachable balloon system was described that accomplishes this task without surgery [3] . The use of coils or occluding spring emboli (Cook, Bloomington, IN) for transcatheter arterial occlusion, first described by Gianturco et al. [4] in 1975, has received little attention in the neuroradiologic literature, save for two case reports involving branches of the external carotid artery, a venous sac [5, 6] , and a case of vertebral artery occlusion for control of hemorrhage [7]. To our knowledge no cases have been reported using this device for transcatheter carotid occlusion. We report the use of coils for this purpose in two patients with internal carotid aneurysms: one in conjunction with detachable balloons and one in which coils were used as the only therapy in an effort to prevent exsanguination.