Temporary balloon occlusion during the surgical treatment of giant paraclinoid and vertebrobasilar aneurysms

We propose the combined neurosurgical-endovascular treatment with the balloon occlusion of parent artery during surgery of giant paraclinoid and vertebrobasilar aneurysms, which are unsuitable for a pure endovascular or surgical approach. Between January 2003 and December 2007, we treated surgically 15 giant aneurysms (11 paraclinoid and four vertebrobasilar) with the combined approach of surgery and endovascular intraoperative technique. Complete aneurysm occlusion was achieved in all 15 aneurysms, as confirmed by intraoperative angiographic control. In one paraclinoid aneurysm, a small recurrence became evident 1 year after surgery and needed coil embolisation. The temporary balloon occlusion technique is useful and improves the safety of the unavoidable exposure of the parent artery in the surgical treatment of giant paraclinoid and vertebrobasilar aneurysms.