Magnetic probe for the stereotactic thrombosis of intracranial aneurysms.

The development of a method for the stereotactic thrombosis of intracranial aneurysms should significantly reduce the morbidity and mortality associated with this disease. By removing the necessity for visual exposure of the aneurysm, stereotactic surgery overcomes the problems of brain retraction and manipulation of blood vessels which constitute the major limiting factors in current surgical therapy (McKissock, Richardson, and Walsh, 1962). Moreover, because a stereotactic probe is inserted through a small burr hole, the operation can be performed under local anaesthesia. Consequently, it may be possible to institute stereotactic surgery immediately after the patient is admitted to the hospital and thereby remove the risk of recurrent haemorrhage which accompanies the prevailing practice of delayed treatment. The techniques of stereotaxis have been adequately developed to allow accurate placing of a probe against an intracranial aneurysm, but an effective means of thrombosing aneurysms has not been available. We have previously reported a technique for creating a focal intra-arterial thrombus by the attraction of intravascular iron powder to an extravascular magnet (Alksne and Fingerhut, 1965; Alksne, Fingerhut, and Rand, 1966a and b; Fingerhut and Alksne, 1966). On the basis of our laboratory experiments, we have developed a magnetic stereotactic probe for clinical use which is inexpensive, easy to use, and effective. The con:struction and use of this probe is the subject of this report.