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Research ArticleINTERVENTIONAL

Venous Phase Timing during Balloon Test Occlusion as a Criterion for Permanent Internal Carotid Artery Sacrifice

Daniel Giansante Abud, Laurent Spelle, Michel Piotin, Charbel Mounayer, Jose Ricardo Vanzin and Jacques Moret
American Journal of Neuroradiology November 2005, 26 (10) 2602-2609;
Daniel Giansante Abud
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Laurent Spelle
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Michel Piotin
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Charbel Mounayer
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Jose Ricardo Vanzin
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Jacques Moret
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    Fig 1.

    Angiogram AP view demonstrates a right carotid occlusion test in a 42-year-old woman with large ICA aneurysm. A and B, Late arterial phase demonstrates excellent cross-filling by Acom. C, Early venous phase—1 second after second image—shows the beginning of venous phase in both sides (black arrows). D, One second later, the venous phase synchronous becomes more evident in both hemispheres (black arrows). This patient represents an example of perfect symmetry of venous phase delay during BTO.

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    Fig 2.

    Angiographic AP view demonstrates a right carotid occlusion test in a 45-year-old man with a large cervical tumor. A, Late arterial phase demonstrates excellent cross-filling through Acom. B, One second after the previous image, beginning of venous phase on the left side (white arrow) and still some cortical arteries in the right hemisphere (indicated as 0 seconds). C, One second later, there are still cortical arteries on right side and veins on the left side (white arrow). D, One second later (ie, venous phase on 2 seconds) shows the veins filled in both hemispheres (black arrow on the right side and white arrow on the left side). This patient had a 2-second venous drainage delay, and permanent occlusion was performed at the same time.

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    Fig 3.
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    Fig 3.

    A 15-year-old girl test occlusion for a right giant ICA aneurysm. A, Angiogram AP view, injected by left ICA shows late arterial phase. B and C, Early and late venous phases, respectively, demonstrate perfect synchronous venous filling of left hemisphere and territory of right anterior cerebral artery through Acom. D, Arterial phase of the injection through left vertebral artery, AP view, demonstrates excellent cross-filling through Pcom. E and F, Early and late venous phases, respectively, show symmetry of venous filling of vertebrobasilar territory and right MCA territory through the right Pcom. This patient presented a supply of the right internal carotid artery territory via both Acom and Pcom, without venous delay. ICA permanent occlusion was performed at the same time.

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    TABLE 1:

    Medical diagnosis in 60 patients undergoing balloon test occlusion of the internal carotid artery followed immediately by therapeutic occlusion, according to gender

    AneurysmsTumorsFistulaeTotal
    Female284133
    Male719127
    Total3523260
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    TABLE 2:

    Venous drainage delay assessed by angiography during balloon test occlusion in 60 patients undergoing permanent internal carotid artery occlusion

    Venous Drainage Delay*0 Seconds1 Second2 Seconds3 SecondsTotal
    Aneurysms2662135
    Tumors1641223
    Direct fistulae20002
    Total44103360
    • * Beginning of venous phase is determined by appearance of first cortical veins at the angiogram. Venous drainage delay corresponds to cortical vein–filling delay of the occluded territory compared to the injected artery (contralateral internal carotid artery or dominant vertebral artery).

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American Journal of Neuroradiology: 26 (10)
American Journal of Neuroradiology
Vol. 26, Issue 10
1 Nov 2005
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Cite this article
Daniel Giansante Abud, Laurent Spelle, Michel Piotin, Charbel Mounayer, Jose Ricardo Vanzin, Jacques Moret
Venous Phase Timing during Balloon Test Occlusion as a Criterion for Permanent Internal Carotid Artery Sacrifice
American Journal of Neuroradiology Nov 2005, 26 (10) 2602-2609;

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Venous Phase Timing during Balloon Test Occlusion as a Criterion for Permanent Internal Carotid Artery Sacrifice
Daniel Giansante Abud, Laurent Spelle, Michel Piotin, Charbel Mounayer, Jose Ricardo Vanzin, Jacques Moret
American Journal of Neuroradiology Nov 2005, 26 (10) 2602-2609;
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  • Therapeutic Internal Carotid Artery Occlusion for Large and Giant Aneurysms: A Single Center Cohort of 146 Patients
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