[Intravascular embolization by the so-called balloonization method in the treatment of cerebral arteriovenous...

The authors describe the method of baloonization used in the treatment of intracranial vascular anomalies. The method was used in the treatment of 7 cases with these anomalies in a period from 1979 up to now. For the procedure patients were qualified after angiography. In 4 cases this investigation showed presence of carotid-cavernous fistula which developed in 3 cases after trauma and in one cases spontaneously. In another 3 patients arteriovenous angioma was diagnosed, in 2 of them the malformation was situation in the cerebral hemisphere and in one in the coverings of the skull. In only one cases the general condition of the patient was severe before the procedure. In 5 cases the procedure was performed under local anaesthesia puncturing directly the common carotid artery, while in two other cases the carotid artery was exposed surgically. Catheters with baloons used for the procedure were made in the centre where the authors were working. Early therapeutic results were estimated on the basis of angiography performed after the end of the procedure. In 4 patients with carotid-cavernous fistulas the abnormal communication was closed with baloons filled with autopolymerising substances, in 2 of these cases the blood flow through the internal carotid artery to the brain was preserved after the procedure. In the group of patients with arteriovenous angiomas cure was obtained in one case (reported), improvement in another, and the third patient remained unimproved. Late results were estimated after 2 - 8 months of follow up. The condition of the patient was evaluated by control outpatient examination which showed that in 6 cases it was satisfactory and in one unchanged. The method is simple and effective, especially in cases of carotid-cavernous fistula, and safe since no complications were observed. The method should be regarded as treatment of choice when the usual surgical intervention is dangerous.