We report 2 cases of parent artery occlusion (PAO) for anterior cerebral artery (ACA) fusiform aneurysm embolization after superselective provocative testing was performed to confirm distal territory viability. The first case involves a patient in the second decade of life who presented with subarachnoid hemorrhage and underwent PAO after a balloon test occlusion in the distal ACA revealed no neurophysiology changes. The second case involves another patient in the forth decade of life who presented with an enlarging pseudoaneurysm and underwent PAO after a sodium amobarbital infusion in the distal ACA revealed no clinical change. Both patients tolerated PAO without clinical compromise. PAO after provocative testing may be a safe and effective strategy in the management of fusiform aneurysm treatment. KEY MESSAGES Provocative testing with superselective balloon test occlusion and sodium amobarbital infusion are both viable options for clinical and physiological interrogation of brain tissue prior to parent vessel occlusion. Neurophysiological monitoring may be a useful surrogate for clinical examination after provocative testing, particularly if patients were treated under general anesthesia.

中文翻译：

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前脑动脉梭状动脉瘤栓塞术前的激发试验。

我们报告了 2 例用于大脑前动脉 (ACA) 梭形动脉瘤栓塞的母动脉闭塞 (PAO) 的病例，这些病例是在进行超选择性激发试验以确认远端区域的活力后进行的。第一个案例涉及一名在生命的第二个十年中出现蛛网膜下腔出血并在远端 ACA 进行球囊测试闭塞后接受 PAO 的患者，显示没有神经生理学变化。第二个病例涉及另一名生命 40 岁的患者，他出现扩大的假性动脉瘤，并在 ACA 远端输注阿莫巴比妥钠后接受 PAO，显示没有临床变化。两名患者均耐受 PAO 而没有临床损害。激发试验后的 PAO 可能是梭状动脉瘤治疗管理中安全有效的策略。关键信息 超选择性球囊测试闭塞和戊巴比妥钠输注的挑衅性测试都是在母血管闭塞之前对脑组织进行临床和生理检查的可行选择。神经生理学监测可能是激发试验后临床检查的有用替代物，特别是如果患者在全身麻醉下治疗。