Occlusion balloon

Removal of balloon-occlusive EPDs is preceded by aspiration of 50-60 ml of blood using a dedicated catheter. Filter-based EPDs are removed using a dedicated retrieval catheter. Difficulties in advancing the retrieval catheter through the stent are at time eliminated by having the patient rotate his/her neck. Rarely, the filter can become obstructed by large amounts of embolic material and blood flow in the ICA is interrupted. Facile technique and optimal antiplatelet therapy prevent this complication in most cases. 

Careful attention must be paid to the segment of the ICA that contained the EPD. Rarely, the embolic protection device causes a dissection in the distal ICA. The risk of this complication is probably greater with balloon-occlusive devices then... 

G. W. Stone, C. Rogers, J. Hermiller, R. Feldman, P. Hall, R. Haber, A. Masud, P. Cambier, R. P. Caputo, M. Turco, R. Kovach, B. Brodie, H. C. Herrmann, R. E. Kuntz, J. J. Popma, S. Ramec and D. A. Cox, Randomized comparison of distal protection with a filter-based catheter and a balloon occlusion and aspiration system during percutaneous intervention of diseased saphenous vein aorto-coronary bypass grafts, Circulation 108, 548-553 (2003). 

Adequacy of collateral circulation when distal balloon occlusion or flow-reversal is considered. 

Dubois J, Garel L, Grignon A, Lemay M, Leduc L (1997) Placenta percreta balloon occlusion and embolization of the internal iliac arteries to reduce intraoperative blood losses. Am J Obstet Gynecol 176 723-726... 

Kidney D, Nguyen MA, Ahdoot D, Bickmore D, Deutsch LS, Majors C (2001) Prophylactic perioperative hypogastric artery balloon occlusion in abnormal placentation. AJR Am J Roentgenol 176 1521-1524... 

A patient s ability to tolerate IIA embolization may be tested by temporary balloon occlusion of the target artery and measurement of the penile brachial index (PBI) pre and post IIA balloon occlusion. This can assess the risk of post procedure impotence. A... 

Another reliable measure of poor circulation to colon is the direct quantification of mucosal oxygenation by a rectal probe [34], A small disposable rectal probe with an atraumatic tip is inserted into the rectum and oxygenation of the mucosa measured. If the levels drop below a certain critical level after balloon occlusion of the IIA, that patient is not a candidate for IIA embolization. 

Despite these advances, occlusion of the parent artery is sometimes necessary because of the wide aneurysm neck. Balloon occlusion of the ICA is a reliable treatment for intracavernous giant aneurysms. In a series of 58 patients, Larson etd. (1995) reported a morbidity rate of 10% caused by transient cerebral ischemia, a permanent ischemic morbidity rate of 5%, and mortality rate of 5%. The authors reported a good resolution of cranial nerve deficits and visual... 

Fig. 5. 52. a,b Large paraophthalmic broad-based ICA aneurysm extending cranially superior to the clinoid process with partial calcification, c Evacuation trapping technique during clipping was performed after transient balloon occlusion of the left internal carotid artery... 

Larson JJ, Tew JM Jr, Tomsick TA, van Loveren HR (1995) Treatment of aneurysms of the internal carotid artery by intravascular balloon occlusion long-term follow-up of 58 patients. Neurosurgery 36 26-30 discussion 30... 

In some cases, identification of a lateral venons branch in which to place a left ventricular lead is not immediately visualized. Most commonly, this is because either an insufficient mount of dye retrogradely filled aU venous branches due to poor balloon occlusion, the balloon itself occlnded the proximal aspect of an eligible lateral vessel, or another more proximal branch was not visualized due to distal balloon or angiographic catheter placement. In these cases, withdrawing the sheath to the ostium of the coronary sinns and performing a hand injection at this location will often identify a vessel snpplying the lateral wall when none was previously seen. 

Kawase, Y., Hoshino, K., Yoneyama, R., et al. (2005) In vivo volumetric analysis of coronary stent using optical coherence tomography with a novel balloon occlusion-flushing catheter A comparison with intravascular ultrasound. Ultrasound in Medicine Biology, 31, 1343. 

Guadagni S, Fiorentini G, Palumbo G et al (2001) Hypoxic pelvic perfusion with mitomycin C using a simplified balloon- occlusion technique in the treatment of patients with unresectable locally recurrent rectal cancer. Arch Surg 136(1) 105-112... 

Wanebo HJ, Chung MA, Levy AI, Turk PS, Vezeridis MP, Bel-liveau JF (1996) Preoperative therapy for advanced pelvic malignancy by isolatedpelvic perfusion with the balloon-occlusion technique. Ann Surg Oncol 3(3) 295-303 Wieberdinck K, Benckhuijsen C, Braat RP et al (1982) Dosimetry in isolation perfusion of the limbs by assessment of perfused tissue volume and grading of toxic tissue reactions. Eur J Cancer Clin Oncol 18 905-910... 

Hepatic outflow obstruction by balloon occlusion of the hepatic vein and combination with hepatic artery block can cause larger areas of coagulation with microwave coagulation therapy (Hiraki and Kanazawa 2005 Shibata et al. 2002b). However, clinical trials are required to define the role of this combined therapy in the treatment of liver tumors. 

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