title: Double-lumen balloon for Onyx® embolization via extracranial arteries in transverse sigmoid dural arteriovenous fistulas: initial experience.
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.
authors: Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, 47, Bd de l'Hôpital, 75013, Paris, France. fredclare5@msn.com.|Paris VI University Pierre et Marie Curie, Paris, France. fredclare5@msn.com.
authors: Frédéric
authors: F
authors: Clarençon
authors: Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, 47, Bd de l'Hôpital, 75013, Paris, France.
authors: Federico
authors: F
authors: Di Maria
authors: Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, 47, Bd de l'Hôpital, 75013, Paris, France.|Paris VI University Pierre et Marie Curie, Paris, France.
authors: Joseph
authors: J
authors: Gabrieli
authors: Department of Neurosurgery, Pitié-Salpêtrière Hospital, Paris, France.
authors: Alexandre
authors: A
authors: Carpentier
authors: Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, 47, Bd de l'Hôpital, 75013, Paris, France.
authors: Silvia
authors: S
authors: Pistochi
authors: Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, 47, Bd de l'Hôpital, 75013, Paris, France.
authors: Bruno
authors: B
authors: Bartolini
authors: Department of Anesthesiology, Pitié-Salpêtrière Hospital, Paris, France.
authors: Chiheb
authors: C
authors: Zeghal
authors: Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, 47, Bd de l'Hôpital, 75013, Paris, France.|Paris VI University Pierre et Marie Curie, Paris, France.
authors: Jacques
authors: J
authors: Chiras
authors: Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, 47, Bd de l'Hôpital, 75013, Paris, France.
authors: Nader-Antoine
authors: NA
authors: Sourour
mesh_terms: D000328:Adult; D020785:Central Nervous System Vascular Malformations / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D013699:Temporal Arteries / Q000473:pathology
keywords: Double lumen balloon; Dural arteriovenous fistula; Embolization; Occipital artery; Onyx®; Superficial temporal artery; Transverse sinus