Retrograde suction decompression of paraclinoid aneurysm--a revised technique.

BACKGROUND

Aneurysms of the ophthalmic segment of the carotid artery are difficult lesions to handle. Batjer and Samson described the technique of suction decompression of the aneurysm by inserting a needle and aspirating blood from the internal carotid artery in the neck. However, this method carries a risk of arterial dissection and distal embolization.

METHOD: We describe a revised technique for suction decompression of paraclinoid aneurysms. The method makes use of the anatomical advantage of the carotid bifurcation. Instead of direct clamping of the internal carotid artery, we isolated the common and external carotid arteries and decompressed the aneurysm via the external carotid artery. We also saved the aspirated blood for autotransfusion.

RESULTS

We have used this technique in two elderly patients with good results.

CONCLUSION

This technique avoids dissection of the internal carotid artery and minimizes the risk of embolization.