• Frédéric Clarençon, Aurelien Nouet, Aimée Redondo, Federico Di Maria, Christina Iosif, Lise Le Jean, Jacques Chiras, and Nader Sourour.
• Department of Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France. fredclare5@msn.com
• BMJ Case Rep. 2013 Jan 1; 2013.

AbstractA 29-year-old patient attended our institution for recurrent strokes related to a giant partially thrombosed M1 aneurysm. Superficial temporal artery-middle cerebral artery (STA-MCA) bypass and subsequent occlusion of both the aneurysm and the dysplastic M1 segment were planned. However, owing to the shortness of the non-dysplastic segment of M1 and the risk of occlusion of the lenticulostriate arteries, the use of a double-lumen balloon was considered for coiling and subsequent injection of Onyx. STA-MCA bypass was performed using a regular technique. Endovascular occlusion of both the aneurysm and the parent artery was subsequently performed by means of coils and Onyx-34 that was injected via the Ascent balloon under balloon inflation. No complications were recorded and no stroke was observed on control MRI. The injection of Onyx-34 through a double-lumen balloon under balloon inflation is a quick and safe technique for precise occlusion of a parent artery.

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