{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T20:29:07Z","timestamp":1772915347307,"version":"3.50.1"},"reference-count":14,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1987,1]]},"abstract":"<jats:p content-type=\"fine-print\">\u2713 Of 68 patients with unclippable aneurysms treated by proximal artery occlusion with detachable balloons, permanent occlusion was achieved in 65; of these patients, 37 had carotid artery aneurysms below the origin of the ophthalmic artery, 21 had aneurysms arising from the supraclinoid portion of the carotid artery, six had basilar trunk aneurysms, and one had a distal vertebral aneurysm. Examination for treatment selection included assessment of the circle of Willis by compression angiography and xenon blood flow studies, with the ultimate evaluation being test occlusion under systemic heparinization with the balloon temporarily placed in the desired position. Of 67 patients who underwent a formal occlusion test, eight with carotid artery aneurysms did not initially tolerate the occlusion test, and ischemic signs disappeared instantaneously with deflation and removal of the balloon. During test occlusion, two additional patients had ischemic events that proved to be embolic; these reversed immediately upon balloon deflation.<\/jats:p>\n<jats:p content-type=\"fine-print\">Of the 65 patients in whom permanent occlusion was effected by detachable balloon, there were nine instances of delayed cerebral events. One of these was a seizure leading to respiratory arrest and resuscitation 3 days following occlusion in a patient who had presented with seizures. The other eight cases were delayed ischemic events; seven were completely reversed and one patient had residual weakness in one leg (1.5% permanent morbidity). Extracranial-intracranial bypass procedures were performed in 25 of the 65 cases. All aneurysms of the carotid artery below the level of the ophthalmic artery presented angiographic proof of complete thrombosis. Ten of 21 aneurysms arising from the supraclinoid portion of the carotid artery were completely thrombosed by proximal occlusion alone, without additional trapping procedures. Similarly, in three of six basilar trunk aneurysms, proximal occlusion alone initiated complete aneurysm thrombosis without trapping. The conclusion is that proximal balloon occlusion for unclippable cerebral aneurysms is a convenient, safe, and effective way of producing arterial occlusion in these cases.<\/jats:p>","DOI":"10.3171\/jns.1987.66.1.0040","type":"journal-article","created":{"date-parts":[[2009,5,8]],"date-time":"2009-05-08T16:17:54Z","timestamp":1241799474000},"page":"40-46","source":"Crossref","is-referenced-by-count":325,"title":["Use of detachable balloons for proximal artery occlusion in the treatment of unclippable cerebral aneurysms"],"prefix":"10.3171","volume":"66","author":[{"given":"Allan J.","family":"Fox","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernando","family":"Vi\u00f1uela","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David M.","family":"Pelz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sydney J.","family":"Peerless","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gary G.","family":"Ferguson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles G.","family":"Drake","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerard","family":"Debrun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Surg Neurol","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/0090-3019(84)90392-6","article-title":"Transvascular treatment of giant aneurysms of the cavernous carotid and vertebral arteries. Functional investigation and embolization.","volume":"21","author":"Berenstein","year":"1984"},{"key":"b2","series-title":"AJNR","first-page":"167","article-title":"Giant unclippable aneurysms: treatment with detachable balloons.","volume":"2","author":"Debrun","year":"1981"},{"key":"b3","series-title":"AJNR","first-page":"337","article-title":"Aspirin and systemic heparinization in diagnostic and interventional neuroradiology.","volume":"3","author":"Debrun","year":"1982"},{"key":"b4","series-title":"Clin Neurosurg","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1093\/neurosurgery\/26.CN_suppl_1.12","article-title":"Giant intracranial aneurysms: experience with surgical treatment in 174 patients.","volume":"26","author":"Drake","year":"1979"},{"key":"b5","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"255","DOI":"10.3171\/jns.1975.43.3.0255","article-title":"Ligation of the vertebral (unilateral or bilateral) or basilar artery in the treatment of large intracranial aneurysms.","volume":"43","author":"Drake","year":"1975"},{"key":"b6","series-title":"Clin Neurosurg","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1093\/neurosurgery\/27.CN_suppl_1.263","article-title":"Carotid-ophthalmic aneurysms: the surgical management of those cases presenting with compression of the optic nerves and chiasm alone.","volume":"27","author":"Ferguson","year":"1980"},{"key":"b7","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3171\/jns.1980.52.1.0001","article-title":"Treatment of intracavernous and giant carotid aneurysms by combined internal carotid ligation and extra- to intracranial bypass.","volume":"52","author":"Gelber","year":"1980"},{"key":"b8","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1227\/00006123-197910000-00001","article-title":"Gradual carotid artery occlusion in the treatment of inaccessible internal carotid artery aneurysms.","volume":"5","author":"Giannotta","year":"1979"},{"key":"b9","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"430","DOI":"10.3171\/jns.1983.58.3.0430","article-title":"Migration of detachable mini-balloon from the ICA causing occlusion of the MCA. 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