To the Editor.
—I read with interest the letter by Krieger1 that detailed a number of alternative methods of therapy for intracranial aneurysms.I wish to briefly comment on another effective alternative, the use of detachable balloons deployed with arteriographic guidance, resulting in the occlusion of the artery proximal to the aneurysm. In DeBrun's2,3 series, the use of Silastic detachable balloons for endarterial placement proved to be a safe and effective modality in the treatment of giant supraclinoid and carotid-cavernous aneurysms. My colleagues and I recently reported a case4 that illustrated the use of this technique in the treatment of multiple large intracranial aneurysms in a patient with a port-wine nevus. Carotid trapping with clipping or ligation has been employed by neurosurgeons for over 30 years. The reports noted above demonstrate that in some cases the use of intra-arterial balloons may eliminate the need for open operations.
Timothy LR. Balloon Therapy for Cranial Aneurysm. Arch Neurol. 1986;43(8):756. doi:10.1001/archneur.1986.00520080008007
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