PURPOSE To evaluate the usefulness of provocative testing with hypotensive challenge during balloon test occlusion of the internal carotid artery before carotid sacrifice and to correlate tolerance of balloon test occlusion with clinical outcome after carotid artery sacrifice. METHODS Forty-seven consecutive cases of balloon test occlusions performed at our institution during the past 4 years...

Occlusio Supra Occlusionem: Intracranial Occlusions Following Carotid Thrombosis as Diagnosed by Cerebral Angiography • Collateral circulation between internal and external carotid arteries was sufficient to thoroughly opacify the middle cerebral artery on cerebral angiography in 11 of 100 patients with internal carotid occlusion. In four of the 11, the branches of the middle cerebral were inta...

A battery of simple noninvasive tests consisting of directional Doppler ultrasound and carotid phonoangiography has been used to detect carotid stenosis in 700 patients Forty four carotid occlusions in 42 patients were confirmed on angiography, and this study examines the accuracy of this noninvasive battery in predicting the presence of an occluded internal carotid artery. Although the sensiti...

Currently, most carotid artery pathologic abnormalities resulting in pseudoaneurysm formation or stenosis are repaired by surgical intervention. Because surgical intervention requires proximal and distal control of the artery, pseudoaneurysms near the skull base may be very difficult to repair and pose greater risk to the patient. As a result, endovascular techniques have evolved in an effort t...

We describe a technique to predict preoperatively the safety of permanently occluding an internal carotid artery. The method was performed by imaging stable xenon cerebral blood flow (CBF) with the internal carotid artery both open and temporarily occluded with a nondetachable balloon on a double lumen Swan-Ganz catheter. Patients were those in whom we planned to sacrifice the internal carotid ...

BACKGROUND AND PURPOSE Stroke severity in cases of hyperacute carotid ischemic stroke may be related to site of arterial occlusion. We evaluated the relationships between National Institutes of Health Stroke Scale (NIHSS) scores and findings on intra-arterial digital subtraction angiograms (IA-DSA) of patients with ischemic stroke within 6 hr of stroke onset. METHODS A total of 43 consecutive...

BACKGROUND AND PURPOSE Prior to their relatively recent FDA approval, detachable balloons for endovascular arterial occlusion had been available on only a limited basis. We evaluated the feasibility of permanent endovascular carotid and vertebral artery occlusion using microcoils deployed with and without proximal flow arrest in 19 patients. METHODS Permanent endovascular occlusion was perfor...