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Double-lumen balloon for Onyx® embolization via extracranial arteries in transverse sigmoid dural arteriovenous fistulas: initial experience

  • Technical Note - Vascular
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An Erratum to this article was published on 20 August 2016

Abstract

Transverse-sigmoid dural arteriovenous fistulas (TS DAVFs) can be challenging to treat by endovascular means. Indeed, a total cure of the fistula can only be achieved when complete occlusion of the fistulous point(s) is obtained by penetration of the embolic agent. However, in some cases, especially for transosseous branches from extracranial arteries like the occipital artery (OcA) or the superficial temporal artery (STA), such penetration is usually poor, leading to major proximal reflux and incomplete fistula obliteration. We present three cases of embolization in two patients with TS DAVF through the OcA and/or the STA with Onyx® using a double-lumen balloon (Microvention, Tustin, CA, USA). This technique allows the penetration of the embolic agent in the transosseous branches by forming a counter-pressure with the inflated balloon. This technique may be useful to achieve complete occlusion of TS DAVFs by endovascular means.

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Fig. 1
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Abbreviations

APA:

Ascending pharyngeal artery

DAVF:

Dural arteriovenous fistula

DMSO:

Dimethyl sulfoxide

EVOH:

Ethylene vinyl alcohol

LMWH:

Low molecular weight heparin

MMA:

Middle meningeal artery

OcA:

Occipital artery

PMA:

Posterior meningeal artery

STA:

Superficial temporal artery

TS DAVF:

Transverse-sigmoid dural arteriovenous fistula

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Authors and Affiliations

  1. Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, 47, Bd de l’Hôpital, 75013, Paris, France

    Frédéric Clarençon, Federico Di Maria, Joseph Gabrieli, Silvia Pistochi, Bruno Bartolini, Jacques Chiras & Nader-Antoine Sourour

  2. Paris VI University Pierre et Marie Curie, Paris, France

    Frédéric Clarençon, Joseph Gabrieli & Jacques Chiras

  3. Department of Neurosurgery, Pitié-Salpêtrière Hospital, Paris, France

    Alexandre Carpentier

  4. Department of Anesthesiology, Pitié-Salpêtrière Hospital, Paris, France

    Chiheb Zeghal

Authors
  1. Frédéric Clarençon
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  2. Federico Di Maria
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  3. Joseph Gabrieli
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  4. Alexandre Carpentier
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  5. Silvia Pistochi
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  6. Bruno Bartolini
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  7. Chiheb Zeghal
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  8. Jacques Chiras
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  9. Nader-Antoine Sourour
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Corresponding author

Correspondence to Frédéric Clarençon.

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Conflict of interest

FC is consultant for Covidien (paid lectures) and Codman (study core lab). NS is proctor for the Pipeline Embolization Device and Medina Embolization device (eV3/Covidien).

Funding

No funding was received for this research.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

For this type of study formal consent is not required.

Additional information

An erratum to this article can be found at http://dx.doi.org/10.1007/s00701-016-2943-9.

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Clarençon, F., Di Maria, F., Gabrieli, J. et al. Double-lumen balloon for Onyx® embolization via extracranial arteries in transverse sigmoid dural arteriovenous fistulas: initial experience. Acta Neurochir 158, 1917–1923 (2016). https://doi.org/10.1007/s00701-016-2906-1

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  • DOI: https://doi.org/10.1007/s00701-016-2906-1

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