Endovascular treatment of dural arteriovenous fistulas using dual lumen balloon microcatheter: technical aspects and results.
OBJECTIVE
We report our results of our experience using transarterial balloon-assisted embolization of aggressive DAVFs using a dual lumen balloon microcatheter. The advantages and disadvantages of this technique when compared to different Onyx embolization techniques are discussed.


METHODS
All patients with aggressive DAVFs who were treated with Onyx using transarterial balloon-assisted technique with a dual lumen balloon microcatheter were included. Clinical presentation, location of DAVF, Borden type, dual lumen balloon microcatheter used, amount of Onyx used, Onyx injection duration, complications, immediate angiographic and follow up results were included in the analysis.


RESULTS
Five patients fulfilled the selection criteria. Their ages ranged from 24 to 62 years old. In 4 cases the dual lumen balloon microcatheter was a Scepter-C 4mm×10mm (Microvention, Tustin, CA); in the other patient the device used was an Ascent 4mm×10mm (Codman, Raynham, MA). In all 5 patients the dual lumen balloon microcatheter was used with the objective to cure the lesion and it was successful in all 5 cases. There was no vessel injury, unwanted embolization, retained microcather, microcatheter rupture or cranial nerve deficits in our series. Our mean Onyx injection time was 6.4min (range from 2 to 10min). There were no procedural complications in our series. Four out of 5 patients had angiographic follow up demonstrating persistent angiographic cure (follow up mean 6 months - range 4-7 months).


CONCLUSIONS
Our experience in this small series of patients indicates that the use of dual lumen balloon microcatheters is safe and feasible, facilitating the use of Onyx for embolization of DAVFs.
Division of NeuroInterventional Surgery, Baptist Cardiac & Vascular Institute and Baptist Neuroscience Center, Miami, USA. Electronic address: guilhermed@baptisthealth.net.
Guilherme
G
Dabus
Division of NeuroInterventional Surgery, Baptist Cardiac & Vascular Institute and Baptist Neuroscience Center, Miami, USA.
Italo
I
Linfante
Department of Interventional Neuroradiology and Radiology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
Mario
M
Martínez-Galdámez
D021721:Balloon Occlusion; D002405:Catheterization, Central Venous; D020785:Central Nervous System Vascular Malformations / Q000601:surgery* / Q000628:therapy; D002533:Cerebral Angiography; D006259:Craniocerebral Trauma / Q000150:complications; D004338:Drug Combinations; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D057510:Endovascular Procedures / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011145:Polyvinyls; D011183:Postoperative Complications / Q000473:pathology; D013635:Tantalum; D055815:Young Adult
D004338:Drug Combinations; C558446:Onyx 18; D011145:Polyvinyls; D013635:Tantalum
Balloon; Dural arteriovenous fistula; Embolization; Endovascular; Transarterial