Abstract
The balloon occlusion test is particularly useful as a preoperative evaluation procedure when it is planned to occlude a major artery temporarily or permanently. In patients with internal carotid artery stenosis, the lesion is usually located very near the bifurcation of the common carotid artery. In the conventional test occlusion using a single-balloon catheter, the balloon should be introduced and inflated at or distal to the stenotic lesion, which may cause thromboemolism and/or intimal dissection of the artery. To avoid this complication, occlusion of the internal carotid artery is performed by occluding both the external and common carotid arteries simultaneously using a double-balloon catheter. Using this method, the ballon occlusion test of the carotid artery has been successfully carried out in 43 of 44 patients with carotid endarterectomy. There were no complications related to this procedure. In 36 of the 43 patients, neurological symptoms and sings were not seen during test artery occlusion. In these patients, carotid endarterectomy was performed without intraluminal shunts. There were no ischemic complications due to temporary occlusion of the carotid arteries during surgery. In the other 7 patients in whom neurological symptoms and/or singns were seen during test occlusion of the carotid arteries, carotid endartere ctomy was performed using intraluminal shunts. Based on our experience, test occlusion of the carotid artery using a double-balloon catheter is a safe, useful examination that can avoid possible hemodynamic complications of carotid endarterectomy.
