[Super-selective arteriography and embolization of the internal carotid]

The aim of superselective arteriography of the internal carotid is to opacify the small calibre arteries which were only slightly visible or not visible at all previously, to isolate an arterial area and to study its anastomoses and its venous drainage. The use of the balloon probe makes it possible to explore the very winding branches of the carotid siphon and the branches of the Sylvian artery or of the anterior cerebral artery. With a balloon probe pierced at the end, one can inject a contrast substance thereby making it possible to carry out superselective arteriography. With an unpierced balloon probe, a branch of the Sylvian or of the anterior cerebral artery can be temporarily occlused in order to study (in an unanaesthetised patient) the possibility of cutting off this artery without neurological complications when it is supplying a malformation. The various methods of embolisation are reviewed (plastic bells, silicones, detachable balloons) as well as their advantages and their dangers.