metrizamide and Dilatation--Pathologic

Two patients with distal basilar aneurysms were treated with intra-aneurysmal balloon occlusion. After apparently successful therapy, follow-up angiograms demonstrated aneurysm enlargement with balloon migration distally in the sac. Geometric mismatch between the base of the balloons and the aneurysm neck together with transmitted pulsation through the 2-hydroxyl-ethylmethacrylate (HEMA)-filled balloon directly contributed to aneurysm enlargement. In this report, the authors discuss the problems of progressive aneurysm enlargement due to a "water-hammer effect" and the possibility of hemorrhage following subtotal occlusion.

Topics: Adult; Basilar Artery; Catheterization; Dilatation, Pathologic; Humans; Intracranial Aneurysm; Male; Metrizamide; Middle Aged; Polyhydroxyethyl Methacrylate; Pulsatile Flow; Radiography