Article Figures & Data
Figures
- FIG 1.
Schematic representation of tumor embolization using the distal balloon protection technique. First, a GC is placed in the ICA (A). Then, the balloon catheter is guided to the proximity of the bifurcation of the ophthalmic artery (B). Next, a microcatheter is inserted into the MHT or ILT (C). If cannulation is difficult, the microcatheter is guided near the orifice of the MHT or ILT. The balloon is then inflated to occlude the internal carotid and ophthalmic arteries (D). The embolic particles are injected from the microcatheter into the MHT or ILT (E). BC indicates balloon catheter; MC, microcatheter.
- FIG 2.
Schematic representation of aspiration and removal of embolic particle reflux into the internal carotid artery. In the GC method, embolic particles are aspirated and removed using the CG, while the ICA is occluded with a balloon (A). In the AC method, a GC different from the one used for embolization is placed in the common carotid artery (for convenience, the GC is depicted in the ICA), and the AC is guided to the vicinity of the meningohypophyseal or inferolateral trunk to aspirate and remove embolic particles (B). In the AC and FR method, after aspiration and removal of embolic particles by the aspiration method, the balloon GC is inflated to reverse blood flow in the ICA to remove embolic particles more reliably (C). BC indicates balloon catheter; BGC, balloon guide catheter.
- FIG 3.
A case of tumor embolization via the MHT using the distal balloon protection technique. Preoperative tumor embolization was performed for a right falcotentorial meningioma through the right MHT (A and B). In this case, the microcatheter was guided to the vicinity of the orifice of the MHT because cannulation of the microcatheter into the MHT was not possible (C). Next, the ICA and ophthalmic artery were occluded with a balloon (C), and the MHT was embolized with embolic particles. After embolization, the AC was guided to the vicinity of the MHT to aspirate and remove the embolic particles. This step was followed by inflating the balloon GC and deflating the balloon catheter to reverse blood flow in the ICA to remove the embolic particles (D). Finally, complete embolization of the MHT was confirmed (E). Postoperative MR imaging showed no embolic cerebral infarction (F). The black arrow indicates the ophthalmic artery; black arrowhead, MHT; single asterisk, balloon catheter; double asterisk, balloon GC.
