Balloon-assisted transarterial embolization of intracranial dural arteriovenous fistulas

Shi, Zongjie; Loh, Yince; Duckwiler, Gary; Jahan, Reza; Viñuela, Fernando

doi:10.3171/2008.10.jns08119

Cited by 77 publications

(67 citation statements)

References 19 publications

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“…Flow control using coils, acrylics, or temporary balloon occlusion is useful for high-flow shunts to decrease the likelihood of distal embolic migration and to improve the penetration of embolic material into the arteriovenous connections. 29 In this series, 9 of 11 patients were cured by endovascular means. Four had curative embolization through a transvenous approach utilizing coils alone or in combination with Onyx.…”

Section: Discussionmentioning

confidence: 97%

“…In the current era of Onyx for curative embolization of DAVFs, transarterial endovascular occlusion of fistulous connections is the primary treatment technique. [28][29][30] Transvenous embolization continues to be a safe and effective option if the fistula sites can be approached via an amenable venous pathway, such as the inferior petrosal sinus, facial vein, or the vein of Galen. Incomplete fistula occlusion or cavernous sinus packing alone should be avoided because of potential dangerous flow diversion into cortical or deep veins.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Middle Cranial Fossa Sphenoidal Region Dural Arteriovenous Fistulas: Anatomic and Treatment Considerations

Shi¹,

Ziegler²,

Feng³

et al. 2012

AJNR Am J Neuroradiol

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Middle Cranial Fossa Sphenoidal Region Dural Arteriovenous Fistulas: Anatomic and Treatment Considerations

Shi¹,

Ziegler²,

Feng³

et al. 2012

AJNR Am J Neuroradiol

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“…According to our review of the literature, there was no previous report of MMAVF caused by injury of the MMA due to balloon inflation as in our patient. Shi et al 13) reported the effectiveness of proximal occlusion with a balloon (HyperForm; Medtronic, Minneapolis, MN, USA) during TAE for DAVF and suggested a decrease in the shunt flow, improvement in the control of reflux of the embolic agent, and prevention of influx of the embolic agent into so-called dangerous anastomosis as its advantages. Since there have been similar reports using Scepter C (Microvention, Tustin, CA, USA), 14) balloon assistance is an option in treating DAVF.…”

Section: Discussionmentioning

confidence: 99%

A Case of Iatrogenic Middle Meningeal Arteriovenous Fistula That Occurred during Embolization of a Feeding Artery of Dural Arteriovenous Fistula

Kitano

Matsubara

Ogawa

et al. 2017

NOUSHINKEI KEKKANNAI TIRYOU

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Objective: A case of iatrogenic dural arteriovenous fistula that occurred during embolization of a feeding artery for transverse sinus (TS) dural arteriovenous fistula is reported.Case Presentation: A 66-year-old woman suddenly noted pain of the left temporal region and nausea and was emergently transported to our hospital. CT of the head showed left subcortical hemorrhage, and DSA demonstrated a dural arteriovenous fistula at the left TS. Although embolization of the feeding artery was attempted via the middle meningeal artery (MMA), a middle meningeal arteriovenous fistula (MMAVF) developed as the MMA was damaged by intraoperative balloon inflation. The MMA was immediately embolized together with the fistulous opening using n-butyl-2-cyanoacrylate (NBCA) and coils, and no sequelae were observed postoperatively. Conclusion:We experienced dural arteriovenous fistula caused by injury of the feeding artery during endovascular treatment. It must be remembered that iatrogenic arteriovenous fistula is a complication of endovascular treatment that is rare but requires attention.

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“…For DAVFs with high flow, easy reflux or anastomosis with intracranial vessels, it would not be an easy deal to make a better control of Onyx penetration into the fistula. Improper flow or reflux of Onyx may cause unfavorable embolization or even serious complications leaving unexpected prognosis (14).…”

Section: Discussionmentioning

confidence: 99%

Balloon-assisted endovascular treatment of intracranial dural arteriovenous fistulas

Huo

Li²,

Jiang³

et al. 2014

Turkish Neurosurgery

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AIm: Most dural arteriovenous fistulas (DAVFs) can be treated safely and effectively with endovascular Onyx embolization. Balloon-assisted endovascular Onyx embolization of intracranial DAVFs is especially suitable for arterial protection and arterial flow reduction in complicated DAVFs. We systemically report our experience in the use of arterial balloon for Onyx embolization of DAVF and evaluate the clinical outcomes. mATERIAL and mETHods: Clinical records of 12 consecutive DAVFs patients (five women, seven men) treated with arterial balloon-assisted endovascular Onyx embolization were retrospectively collected to analysis their presenting symptoms, angiographic features, endovascular treatments, and clinical outcomes. yÖNTEm ve GEREÇLER: Arteriyel balon yardımlı endovasküler Onyx embolizasyonuyla tedavi edilen 12 DAVF hastasının (beş kadın, yedi erkek) klinik kayıtları, geliş belirtileri, anjiyografik özellikleri, endovasküler tedavileri ve klinik sonuçları analiz edilmek üzere retrospektif olarak toplandı.BuLGuLAR: 6 hasta kortikal venöz reflü (KVR) ile geldi. Dokuz hastaya transarteriyel (TA) ve 3 hastaya transvenöz (TV) embolizasyon yapıldı. Balonlar 3 tür yaklaşımda kullanıldı: TA embolizasyonda arteriyel koruma, TA embolizasyonda arteriyel akış azaltma ve TV yaklaşımında arteriyel koruma. Anjiyogramlar 11 hastada fistülün tam obliterasyonu ve bir hastada kısmi oklüzyon gösterdi. Bir hastada Onyx embolizasyonuyla ilgili olarak geçici hemifasiyal hipoestezi komplikasyonu vardı. soNuÇ: Arteriyel balon, DAVF'nin Onyx embolizasyonunda intrakraniyal arterin korunmasını ve arteriyel akışın azaltılmasını sağlamaktadr. Bu tamamlayıcı yöntem düşük bir komplikasyon oranına sahiptir ve yüksek bir tam iyileşme oranıyla sonuçlanmıştır.

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Balloon-assisted transarterial embolization of intracranial dural arteriovenous fistulas

Abstract: The BAT provides a new complementary method in the transarterial embolization of DAVFs that are not amenable to transvenous embolization. The venous BAT protects the patency of critical venous pathways, whereas the arterial BAT provides better control of the Onyx-based embolization.

Cited by 77 publications

References 19 publications

Middle Cranial Fossa Sphenoidal Region Dural Arteriovenous Fistulas: Anatomic and Treatment Considerations

Middle Cranial Fossa Sphenoidal Region Dural Arteriovenous Fistulas: Anatomic and Treatment Considerations

A Case of Iatrogenic Middle Meningeal Arteriovenous Fistula That Occurred during Embolization of a Feeding Artery of Dural Arteriovenous Fistula

Balloon-assisted endovascular treatment of intracranial dural arteriovenous fistulas

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