Reporting standards for balloon test occlusion

• Published in: Journal of neurointerventional surgery Vol. 5; no. 6; pp. 503 - 505
• Main Authors: Narayanan, S, Singer, R, Abruzzo, T A, Hussain, M S, Powers, C J, Prestigiacomo, C J, Heck, D V, Sunshine, J L, Kelly, M, Jayaraman, M V, Meyers, P M
• Format: Journal Article
• Language: English
• Published: BMA House, Tavistock Square, London, WC1H 9JR BMJ Publishing Group Ltd 01.11.2013; BMJ Publishing Group LTD
• Subjects: Balloon Occlusion - adverse effects; Balloon Occlusion - methods; Carotid arteries; Cerebral Angiography; Cerebrovascular Disorders - diagnosis; Cerebrovascular Disorders - surgery; Dissection; Documentation - standards; Humans; Medical imaging; Mortality; Nervous System Diseases - epidemiology; Nervous System Diseases - etiology; Neurosurgery - standards; Reference Standards; Reproducibility of Results; Skull Base - surgery; Success; Tumors; Veins & arteries; Standards
• ISSN: 1759-8478; 1759-8486
• DOI: 10.1136/neurintsurg-2013-010848

When carotid artery BTO is clinically tolerated, the morbidity and mortality associated with permanent arterial occlusion are reduced but, unfortunately, not eliminated. Since the report of endovascular temporary arterial occlusion presented by Serbinenko 7 was published, a variety of adjunctive methods have been tested to improve the sensitivity and specificity of clinical neurologic evaluation alone for the detection of insufficient cerebral blood flow to allow safe permanent arterial occlusion. Pharmacologic induction of hypotension during BTO has also been used to attempt to elicit clinical signs of inadequate perfusion. 30-32 Indications Indications for BTO include: a fusiform aneurysm/pseudoaneurysm ineligible for treatment with parent vessel sparing techniques; a vessel at risk for occlusion during a complex surgical/endovascular procedure; life threatening hemorrhage related to trauma, neoplasm, radiation necrosis, or infection; cranial and cervical neoplasms with ICA involvement; arterial dissection with continued embolism when antiplatelets/anticoagulation are contraindicated; and direct carotid-cavernous fistula, which may not be treatable with preservation of the parent artery.