Balloon detachable

Detachable balloons were on the market in the US several years ago but were recalled due to both manufacturing problems and the difficulties in accurately placing the balloons. The use of these devices has been replaced by the GDC-type coils which allow the trial placement of a coil and its exchange for another size if the first is incorrect. 

White RI Jr, Ursic TA, Kaufman SL et al (1978) Therapeutic embolization with detachable balloons physi-... 

If structural abnormalities such as vascular malformations, hypervascular tumors, vessel wall irregularities suggesting erosion etc., are visualized, then we may try for a palliative embolization with Gelfoam or particulates. Rarely, curative embolization of an arteriovenous malformation or fistula is achievable with non-resorbable agents, such as glue or detachable balloons. 

Sclerotic agents such as ethanol and polidocanol are pure liquids which penetrate into the capillary bed, causing coagulation necrosis [97] and therefore are not suitable for transarterial embolization. Detachable balloons are very helpful in the rare case of an arteriovenous fistula [98]. 

Defreyne L, De Schrijver I, Vanlangenhove P, et al. (2002) Detachable balloon embolization of an aneurysmal gastroduodenal arterioportal fistula. Eur Radiol 12 231-236... 

Emholic material Steel coils Platinum microcoils if co-axial system used 1. Glue 2. Thrombin 3. Long detachable coils or detachable balloons if the aneurysm must be packed Unless the haemorrhage is immediately life threatening (see Fig. 7.3) do not use Particles Gelfoam Autologous blood... 

The use of percutaneous sclerotherapy as a treatment for varicocele was first described in 1980 [5]. The most commonly used embolization method in the USA, which is the use of metal coils (Fig. 12.2), was described in 1978 [20]. Ever since, additional materials and methods have been reported including modified coils such as the new Amplatz vascular plug, boiling contrast, detachable balloons. 

The use of detachable balloons to occlude the ISV was first described in 1981 [31]. Due to a lack of FDA approval for some of the devices and manufacturer related issues, the balloons have not always been readily available in the USA. From a technical standpoint, balloons were similar to coils in that they needed to be deployed above and below collateral connections. However, since the balloon occluded the vein completely, much like the Amplatz Vascular Plug, only one was necessary at any given site. As with coils, it was common for users of balloons to perform some type of sclerotherapy on the vein segments between balloons to decrease the development of collaterals. Balloons suffered from two major drawbacks that severely limited their more widespread acceptance. The first was cost. The other was that the size of the catheter required to deliver... 

White RI Jr, Kaufman SL, Barth KH, Kadir S, Smyth JW, Walsh PC (1981) Occlusion of varicoreles with detachable balloons. Radiology 139 327-334... 

Stainless steel or platinum coils and detachable balloons are rarely used as aprimaryembolicagentinbron-chial artery embolization. Although these can be used to occlude a pathologic bronchial artery efficiently, use of coils predudes repeat embolization, which is often needed as patients are prone to distal collateralization (Fig. 16.21) [43,44]. The primary indication for use of coils is in patients with a bronchial artery aneurysm. Secondly, in cases where a superselective position of a (micro) catheter cannot be reached, coils can be used to protect a normal distal vascular territory against inadvertent embolization [25]. 

Hieshima GB, Grinnel VS, Mehringer CM (1981) A detachable balloon for therapeutic transcatheter occlusions. Radiology 138 227-228... 

Poliak JS, Egglin TK, Rosenblatt MM, Dickey KW, White RI Jr (1994) Clinical results transvenous systemic embolotherapy with a neuroradiologic detachable balloon. Radiology 191 477-482... 

Saluja S, Sitko I, Lee DW, Poliak J, White RI Jr (1999) Embolotherapy of pulmonary arteriovenous malformations with detachable balloons long-term durability and efficacy. J Vase Interv Radiol 10 883-889... 

White RI Jr, Barth KH, Kaufman SL, de Caprio V, Strand-berg JD (1980) Therapeutic embolization with detachable balloons. CardioVasc Intervent Radiol 3 229-241... 

There is a great variety of different coils currently available. Stainless steel coils have been used for a long time for peripheral embolizations. Due to an attached Dacron fibre they are extremely thrombo-genic, facilitating even parent vessel occlusion. They might be increasingly used for this indication, if detachable balloons are really not available any more. However, for cerebral embolizations they are too stiff. Platinum coils are much softer than stainless steel coils. Meanwhile, there exist different types of CE marked detachable platinum coils provided... 

Higashida RT, Halbach VV, Cahan LD, Hieshima GB, Koni-shi Y (1989) Detachable balloon embolization therapy of posterior circulation intracranial aneurysms. J Neuro-surg 71 512-519... 

Finally the ureter can be blocked permanently by a detachable balloon (Fig. 7.8) or embolized with coils combined with cyanoacrylate glue. Balloons are prone to migration. Cyanoacrylate needs careful handling in order not to glue the embolization catheter to the ureter (Fig. 7.9a-c). 

Fig. 7.8a,b. Patient with malignant vesico-vaginal fistula. The patient had a solitary kidney, a Nephrostomy, b Detachable balloon (filled with contrast medium) occluding the lower ureter... 

Approximately 80% of pulmonary AVMs will be of the simple type with a single feeding artery making them amenable to percutaneous embolization with coils or detachable balloons (Fig. 1.7a,b). 

DeSouza NM, Reidy JF (1992) Embolization with detachable balloons - applications outside the head. Clin Radiol 46 170-175... 

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