Onyx Embolization for Isolated Type Dural Arteriovenous Fistula Using a Dual-Lumen Balloon Catheter.
BACKGROUND
Utilization of a dual-lumen balloon may improve Onyx penetration into isolated dural arteriovenous fistulas (i-DAVFs).


OBJECTIVE
To compare the results of Onyx embolization using a dual-lumen balloon with those using a non-balloon catheter for i-DAVFs.


METHODS
Twenty-nine patients underwent Onyx embolization for i-DAVFs using a non-balloon (n = 14) or a dual-lumen balloon catheter (n = 15). Since its introduction, a dual-lumen balloon catheter has been preferred. We compared the dual-lumen balloon group with the non-balloon catheter group regarding angiographic outcome, treatment-related complications, total procedural time, Onyx injection time, and the number of feeders requiring embolization.


RESULTS
The dual-lumen balloon group showed complete occlusion of i-DAVFs in 13 and near-complete in 2 patients, while the non-balloon group showed complete occlusion in 5, near-complete in 5, and incomplete in 4 patients (P < .05). Treatment-related complications occurred in 2 patients: 1 in the non-balloon group and 1 in the dual-lumen balloon group. The mean total procedural time was 62 ± 32 minutes in the dual-lumen balloon and 171 ± 88 minutes in the non-balloon group (P < .05). The mean Onyx injection time was 10 ± 6 minutes in the dual-lumen balloon and 49 ± 32 minutes in the non-balloon group (P < .05). The median number of feeders requiring embolization was 1 (range, 1-3) in the dual-lumen balloon and 2 (range, 1-4) in the non-balloon group (P < .05).


CONCLUSIONS
Utilization of a dual-lumen balloon catheter for Onyx embolization of i-DAVF seemed to significantly increase the immediate complete occlusion rate and decrease total procedural time, Onyx injection time, and number of feeders requiring embolization.
Departments of *Radiology and‡Neurosurgery, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
Jin Woo
JW
Kim
Byung Moon
BM
Kim
Keun Young
KY
Park
Dong Joon
DJ
Kim
Dong Ik
DI
Kim
D000328:Adult; D000368:Aged; D063125:Balloon Embolectomy / Q000379:methods*; D002404:Catheterization; D057785:Catheters; D020785:Central Nervous System Vascular Malformations / Q000628:therapy*; D004121:Dimethyl Sulfoxide; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011145:Polyvinyls; D012189:Retrospective Studies; D016896:Treatment Outcome
C450660:Onyx copolymer; D011145:Polyvinyls; D004121:Dimethyl Sulfoxide