Original Article Double-Lumen Balloons, Are They Only Useful in Neurointerventions? Preliminary Outcomes of Double-Lumen Balloon-Assisted Embolization of Visceral Artery Aneurysms Yilmaz Onal, MD 1 , Cesur Samanci, MD 2 , and Esin Derin Cicek, MD 1 Abstract Objectives: This study aimed to assess the feasibility and results of double-lumen balloon-assisted embolization of visceral artery aneurysms (VAAs). Methods: Nine patients (mean age, 55.3 + 10.8 years) diagnosed with VAA (superior mesenteric, n ¼ 5; splenic, n ¼ 2; renal, n ¼ 2) and undergoing double-lumen balloon-assisted embolization were included in this study. Magnetic resonance angiogram (MRA) was used in the 6-month follow-up to assess the aneurysms and patency of the parent arteries. Results: All patients were successfully treated with no reports of morbidity or mortality. Residual filling of the aneurysm neck was detected in 2 patients at the end of the procedure, but those parts were found to be stable in the sixth-month MRA. In 1 patient with renal aneurysm, a stent had to be deployed using a double-lumen balloon catheter because of the prolapse of the coil into the main artery. In another patient with a very large-necked superior mesenteric artery aneurysm, additional coils could be used at the same time thanks to the double-lumen balloon as the coils were not stabilized enough during embolization with the microcatheter coils. Liquid embolic agent was also used in this patient from the same lumen because of the large diameter of the aneurysm. Conclusions: Double-lumen balloons, which are mostly used in neurointerventional procedures, can be efficiently used as in the treatment of VAAs due to their ability to deploy stent and perform coil-liquid embolization through 1 lumen. Keywords double-lumen balloons, embolization, visceral artery aneurysms Introduction Although visceral artery aneurysms (VAAs) are rare, their diagnosis is important to avoid potential life-threatening com- plications. With the frequent use of cross-sectional imaging methods, their prevalence is increasing. Aneurysms >2 cm in size is the main indication for treatment because of their asso- ciation with a higher rate of rupture. 1,2 Treatment options, whether surgical or endovascular methods, should protect and maintain the visceral artery patency while disabling the aneur- ysm. Nowadays, endovascular methods are used frequently because of the low perioperative morbidity and shorter hospital stay associated with it. There are a couple of techniques for endovascular treatment of VAAs that are mentioned in the literature. Stent graft and primary coil embolization are well-known options, 3,4 but these both techniques have some drawbacks. In a VAA with a branch located close to the aneurysm, stent graft placement may occlude the branch. Additionally, it may not be possible to advance the stent graft in visceral arteries that have a highly tortuous anatomy. On the other hand, primary embolization may not be possible in wide-necked aneurysms because of the risk of the coil protruding into the parent artery and occluding the visceral artery. There are several studies in the literature on stent-assisted embolization in these situations. 5 Balloon- assisted embolization of these aneurysms, first described by Moret et al, 6 could be a favorable option. The main advantages of the new generation double-lumen balloons are navigation capability, stent deployment, and coil-liquid embolization from 1 lumen. Many articles have published the use of these double-lumen balloons in neurointerventional procedures. 7-9 In this study, we 1 Fatih Sultan Mehmet Training and Research Hospital Radiology Department, Istanbul, Turkey 2 Haydarpas¸a Sultan Abdu¨lhamidhan Training and Research Hospital Radiology Department, Istanbul, Turkey Corresponding Author: Yilmaz Onal, Fatih Sultan Mehmet Training and Research Hospital Radiology Department, E5 u¨zeri _ Ic¸erenko¨y Atas¸ehir/Istanbul, Turkey. Email: dronalylmz@gmail.com Vascular and Endovascular Surgery 1-6 ª The Author(s) 2019 Article reuse guidelines: sagepub.com/journals-permissions DOI: 10.1177/1538574419896516 journals.sagepub.com/home/ves