Abstract
To develop a new balloon catheter technique, three types of detachable balloon catheters, a catheter delivery system and a radiopaque solidifying liquid were prepared. In the first type of detachable balloon catheter, the balloon was detached from the catheter by rotation at the specially designed joint connecting the balloon and catheter. The joint was made of ethylene-vinylalcohol copolymer. In the second type of detachable balloon catheter, the balloon was detached from the catheter by dissolution of a specially designed joint. The joint was made from a polyvinylalcohol tube and had two electrodes. When high frequency electrical current was applied, the resulting heat dissolved the joint within one second. The third detachable balloon catheter was a modification of the second type of catheter. A pinhole was made at the tip of the balloon. Through this pinhole, solidifying liquid such as isobutyl 2-cyanoacrylate can be introduced into the artery. At present, twenty-three superselective catheterizations including nine embolizations have been performed. Eight embolizations were performed in patients with intradural cerebral aneurysms and arteriovenous malformations. Two complications occurred. In arteriovenous malformations, embolization using a detachable balloon catheter seemed to be an effective adjunctive treatment prior to operative removal. In aneurysms, permanent embolization of the neck of the aneurysm appeared to be most important. Posttraumatic carotidcavernous sinus fistulas and some spontaneous carotid-cavernous sinus fistulas could be completely embolized using a detachable balloon catheter while preserving the carotid blood flow.
