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Case report
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
  1. Frédéric Clarençon1,
  2. Aurelien Nouet2,
  3. Aimée Redondo3,
  4. Federico Di Maria1,
  5. Christina Iosif1,
  6. Lise Le Jean4,
  7. Jacques Chiras1,
  8. Nader Sourour1
  1. 1Department of Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France
  2. 2Department of Neurosurgery, Pitié-Salpêtrière Hospital, Paris, France
  3. 3Department of Neurosurgery, Beaujon University Hospital, Clichy, France
  4. 4Department of Intensive Care, Pitié-Salpêtrière Hospital, Paris, France
  1. Correspondence to Dr Frédéric Clarencon, fredclare5{at}msn.com

Abstract

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.

  • Aneurysm
  • Balloon

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