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Monitoring Neuroradiology Procedures

Patients with giant intracranial aneurysms and vascular tumors may undergo temporary balloon occlusion of the internal carotid artery (a neuradiology procedure), to determine cerebral tolerance to exclusion of that vessel if it must be sacrificed. TCD monitoring of the ipsilateral MCA during test occlusion determines the percent change in flow velocity during balloon inflation and documents the collateral pathways. This information compliments the balloon occlusion procedure and can help in identifying the patients who are at risk for hemodynamic stroke following ICA occlusion.

Arteriogram of a giant aneurysm of the intracranial internal carotid artery (ICA). A balloon is inflated into the proximal ICA during test occlusion and the patient is monitored for symptoms. "Click" on above image to view larger.

MCA velocity waveform during ICA test oclusion. With balloon inflation velocity decreases and with balloon deflation the velocity increases. This information is used to help determine if the patient can tolerate sacrifice of the ICA, if necessary to eliminate the aneurysm.